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Pulmonary Medicine
Volume 2011, Article ID 261404, 4 pages
Case Report

Immersion Pulmonary Edema in Female Triathletes

1School of Human Kinetics, University of British Columbia, 210-6081 University Boulevard, Vancouver, BC, Canada
2Division of Sports Medicine, University of British Columbia, Vancouver, BC, Canada

Received 17 March 2011; Revised 11 April 2011; Accepted 12 April 2011

Academic Editor: N. Ambrosino

Copyright © 2011 Eric A. Carter and Michael S. Koehle. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Pulmonary edema has been reported in SCUBA divers, apnea divers, and long-distance swimmers however, no instances of pulmonary edema in triathletes exist in the scientific literature. Pulmonary edema may cause seizures and loss of consciousness which in a water environment may become life threatening. This paper describes pulmonary edema in three female triathletes. Signs and symptoms including cough, fatigue, dyspnea, haemoptysis, and rales may occur within minutes of immersion. Contributing factors include hemodynamic changes due to water immersion, cold exposure, and exertion which elevate cardiac output, causing pulmonary capillary stress failure, resulting in extravasation of fluid into the airspace of the lung. Previous history is a major risk factor. Treatment involves immediate removal from immersion and in more serious cases, hospitalization, and oxygen administration. Immersion pulmonary edema is a critical environmental illness of which triathletes, race organizers, and medical staff, should be made aware.