Chest · 2026
Cardiac Findings in Swimming-Induced Pulmonary Edema: Implications for Acute Assessment.
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Seiler Claudia, Torola Miro, Knuts Ulrika, Holm Lisa, Magnusson Bjarne, Rask Peter, Nilsson Kristofer F, Hårdstedt Maria
Аннотация
BACKGROUND: Pathologic cardiac findings have been described in case reports of patients with swimming-induced pulmonary edema (SIPE).
RESEARCH QUESTION: What are the cardiac findings in patients with SIPE and how are they characterized?
STUDY DESIGN AND METHODS: A cohort study evaluated patients with SIPE and asymptomatic swimmers (control participants) participating in Sweden's largest open-water swimming event, Vansbrosimningen, from 2022 through 2024. Transthoracic echocardiogram (TTE), ECG, and cardiac biomarkers were assessed within 2 hours following swimming and at follow-up within 12 months.
RESULTS: In total, 45 patients with SIPE and 45 control participants were included in the study. Systolic ventricular function on TTE was mildly impaired following swimming in 43% of patients and 10% of control participants (P = .003). Systolic pulmonary artery pressure was increased in 30% of patients but in none of the control participants (P = .005). TTE pathology had improved at follow-up in all but 1 patient. Findings on ECG following swimming showed no difference between groups (P = .746). High-sensitivity cardiac troponin I levels following swimming were increased in 67% of patients and 40% of control participants (median, 47 pg/mL vs 14 pg/mL; P < .001). N-terminal pro-B-type natriuretic peptide levels were higher in patients than in control participants (median, 169 pg/mL vs 65 pg/mL; P < .001). Two patients with myocardial infarction concurrently with SIPE had clinically significant chest pain and high levels of cardiac troponin.
INTERPRETATION: In patients with SIPE, transient mildly affected cardiac function on TTE and a small to moderate elevation of cardiac biomarkers is likely to be found. ECG did not differ between groups. This study provides a reference of expected cardiac findings in patients with SIPE.
CLINICAL TRIAL REGISTRATION: ClinicalTrials.gov; No.: NCT05391737; URL: www.
CLINICALTRIALS: gov.
RESEARCH QUESTION: What are the cardiac findings in patients with SIPE and how are they characterized?
STUDY DESIGN AND METHODS: A cohort study evaluated patients with SIPE and asymptomatic swimmers (control participants) participating in Sweden's largest open-water swimming event, Vansbrosimningen, from 2022 through 2024. Transthoracic echocardiogram (TTE), ECG, and cardiac biomarkers were assessed within 2 hours following swimming and at follow-up within 12 months.
RESULTS: In total, 45 patients with SIPE and 45 control participants were included in the study. Systolic ventricular function on TTE was mildly impaired following swimming in 43% of patients and 10% of control participants (P = .003). Systolic pulmonary artery pressure was increased in 30% of patients but in none of the control participants (P = .005). TTE pathology had improved at follow-up in all but 1 patient. Findings on ECG following swimming showed no difference between groups (P = .746). High-sensitivity cardiac troponin I levels following swimming were increased in 67% of patients and 40% of control participants (median, 47 pg/mL vs 14 pg/mL; P < .001). N-terminal pro-B-type natriuretic peptide levels were higher in patients than in control participants (median, 169 pg/mL vs 65 pg/mL; P < .001). Two patients with myocardial infarction concurrently with SIPE had clinically significant chest pain and high levels of cardiac troponin.
INTERPRETATION: In patients with SIPE, transient mildly affected cardiac function on TTE and a small to moderate elevation of cardiac biomarkers is likely to be found. ECG did not differ between groups. This study provides a reference of expected cardiac findings in patients with SIPE.
CLINICAL TRIAL REGISTRATION: ClinicalTrials.gov; No.: NCT05391737; URL: www.
CLINICALTRIALS: gov.