Best Practice Case Studies-Study Questions (HYPERTENSION IN THE HIGH SEAS)

Pdf Summary

A 32-year-old female triathlete presented with difficulty breathing and chest tightness during an ironman triathlon. Initially, she experienced breathing issues while swimming in a wetsuit, which progressed during the biking phase. She reported coughing up frothy, pink-tinged sputum and experiencing shortness of breath and dizziness, with oxygen saturation at 91%. Despite hydrating well and having no past medical history except for taking multivitamins and fish oil, she developed these symptoms. The correct management was intravenous furosemide administration.<br /><br />The condition is identified as swimming-induced pulmonary edema (SIPE), commonly seen in activities like scuba diving, swimming, and triathlons after cold-water immersion. It is due to a sudden increase in central vascular volume resulting in acute fluid overload and cardiogenic pulmonary edema, exacerbated by factors like cold-water immersion and intense physical activity. Despite considering other diagnoses like pulmonary embolism, SIPE appears most likely due to the context of her symptoms.<br /><br />Treatment in such cases involves removing the individual from water, cessation of physical activity, and in severe cases, symptomatic treatment with oxygen and diuretics like furosemide. Administering a bronchodilator or additional fluids could worsen her condition, given the nature of pulmonary edema. This aligns with the literature suggesting that managing fluid balance is crucial in addressing such cases, especially avoiding further fluid overload.<br /><br />References in the document support the discussion of SIPE in athletes and emphasize the importance of appropriate intervention to prevent worsening of symptoms and restore hemodynamic equilibrium.

Meta Tag

Edition 3rd Edition

Related Case 3rd Edition, CASE 33

Topic Lung

Keywords

swimming-induced pulmonary edema

SIPE

triathlete

ironman triathlon

furosemide

cold-water immersion

cardiogenic pulmonary edema

oxygen saturation

fluid overload

hemodynamic equilibrium

3rd Edition

3rd Edition, CASE 33

Lung