Immersion Pulmonary Edema & ? Afib ?

Below is where you can see our paper on immersion pulmonary edema in Physician & Sports Med. It was prompted after seeing several pts with this problem. I think you can also get immersion afib from fluid redistribution in vulnerable patients. The patient is an athletes (because athletes have larger plasma volumes?) who presents with what sounds like pulmonary edema (white frothy sputum), but only when swimming (often in cold water…more vasoconstriction). They often have a history of “borderline hypertension” or “white coat hypertension” suggesting they have some mild LVH or ventricular relaxation issues. I think there may also be an immersion afib for the same reasons. Management is tough but includes getting them to wear larger wet suits, tighter BP management especially if they have exercise hypertension, and avoiding cold water.

https://www.tandfonline.com/doi/full/10.1080/00913847.2018.1546104#.XMrcXcYisW0.twitter

Paul D. Thompson, MD

Chief of Cardiology — Emeritus, Hartford Hospital

Professor of Medicine, University of Connecticut

Telephone: 860–972–1793

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