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Immersion-Induced Mitral Regurgitation: A Novel Risk Factor for Swimming-Induced Pulmonary Edema.

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Department of Medicine, Duke University Medical Center, Durham, NC; Department of Anesthesiology, Duke University Medical Center, Durham, NC; Center for Hyperbaric Medicine and Environmental Physiology, Duke University Medical Center, Durham, NC. Electronic address:

Immersion pulmonary edema, more commonly referred to as swimming-induced pulmonary edema (SIPE), is a well-documented condition believed to be a result of immersion physiologic condition that is characterized by a peripheral-to-central redistribution of blood volume. It disproportionally affects young, healthy athletes with no clinically overt cardiovascular or pulmonary conditions. We present four cases of healthy athletes with previously documented SIPE, who participated in Institutional Review Board-approved clinical studies that examined the pathophysiologic condition and prevention of SIPE.

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A case of recurrent swimming-induced pulmonary edema in a triathlete: the need for awareness.

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This report discusses a rare case of a 55-year-old female triathlete who developed recurrent episodes of swimming-induced pulmonary edema (SIPE). She had two hospital admissions with pulmonary edema after developing breathlessness while swimming, including a near-drowning experience in an open water swim. With increasing popularity of triathlon and open water sports, this case highlights the importance of a greater awareness of SIPE among health professionals, event organizers, and athletes.

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Holding breath combined with immersion of face in cool water induces diving reflex consisting in bradycardia, peripheral vasoconstriction, and preferential redistribution of blood to the vital organs. The individual responses are variable, highly expressed in young children to weaken with age. Detailed assessment of the cardiac response to diving in late adolescents who are mostly prone to unexpected diving experiments and related complications are of practical importance.

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