Risk factors for immersion pulmonary edema:
(1) scuba diving
(2) apnea (breath-holding) diving
(3) long-distance swimmers
(4) triathletes
Possible explanations:
(1) subclinical cardiac disease
(2) sudden pulmonary hypertension with rupture of small blood vessels
(3) negative pressure pulmonary edema
(4) combination of exertion, sudden cold exposure and comorbid condition
Clinical findings may include:
(1) cough
(2) fatigue
(3) dyspnea
(4) hemoptysis
(5) rales
(6) variable seizures
(7) variable loss of consciousness
(8) pulmonary edema on chest X-ray
It is important to evaluate the patient for underlying heart, lung or other comorbid disease.
