First reported in 1989, SIPE can leave swimmers struggling to breathe and reduce their blood to vital oxygen. It affects an estimated 1–2% of open water swimmers, but cases are likely to be underreported.
The woman, in this case, was in her 50s and a former competitive long-distance swimmer and triathlete. Otherwise, fit and well, she was found struggling for breath and coughing up blood after participating in an open-water swimming event.
The incident took place at night wearing a wetsuit in a water temperature of approximately 17 °C. Her symptoms started after swimming 300 meters. This forced her to skip the event and she was left breathless for a few days afterwards.
On arrival at the hospital, he had a rapid heartbeat, and a chest X-ray revealed pulmonary edema. Further scans showed that fluid had infiltrated the heart muscle, a sign of stress called myocardial edema. But he didn’t have any structural heart disease.
Her symptoms got better within 2 hours of reaching the hospital. And after careful monitoring, he was discharged the next morning. It’s not clear exactly what causes SIPE.
But it does include an increase in arterial pressure in the lungs due to the concentration of blood volume in a cold environment, combined with exaggerated constriction of these blood vessels in response to cold and increased blood flow during physical exertion.
But recurrence is common and has been reported in 13%–22% of scuba divers and swimmers, suggesting a predisposition to the condition.
How to avoid Swimming Induced Pulmonary Edema (SIPE)? Doctors recommend slow swimming, even in warm water, without tight-fitting wetsuits, and avoiding non-steroidal anti-inflammatories, such as ibuprofen, to reduce the risk.
For those experiencing symptoms for the first time, they recommend stopping swimming and getting straight out of the water, then sitting up straight, and calling for medical help if necessary.
This is just one case, more cases are unknown. Therefore, we need to raise awareness among doctors and swimmers about this relatively little known condition.
The UK Diving Medical Committee has published guidance for divers. However, at present, there are no formal national medical guidelines regarding the recognition and management of this complex condition.