Cardiac Function in Swimming-Induced Pulmonary Edema (SIPE)

  • End date
    Dec 29, 2026
  • participants needed
  • sponsor
    Dalarna County Council, Sweden
Updated on 4 October 2022
lung ultrasound
respiratory symptom
diagnostic procedures
Accepts healthy volunteers


Acute or chronic cardiac dysfunction could be a contributing factor to swimming-induced pulmonary edema (SIPE). Knowledge on cardiac function in SIPE is limited and recommendations for cardiac evaluation of patients with SIPE are lacking. The present study was designed to assess cardiac function in patients with SIPE and in asymptomatic swimmers.


Swimming induced pulmonary edema (SIPE) is an unusual condition occuring during swimming in cold open water. SIPE is characterized by acute onset of dyspnea and cough, excessive sputum and occasionally hemoptysis. Reversible myocardial dysfunction has been described in swimmers with SIPE and divers with immersion pulmonary edema (IPE). Cardiac dysfunction has also been discussed as a contributing factor triggering SIPE. However, prevalence, severity and prognosis of myocardial dysfunction in patients with SIPE is unknown. Official recommendations for cardiac evaluation of patients after an acute episode of SIPE is lacking.

This case-control-study intends to assess cardiac function in patients with SIPE and in asymptomatic swimmers. We study a large cohort of approximately 12 000 swimmers during Vansbrosimningen, Sweden's biggest annual open water event, with a yearly incidence of SIPE of about 0,4%. Cardiac function is evaluated after swimming as well as at rest by echocardiography, 12-lead electrocardiogram and cardiac biomarkers (Troponin I, NT-pro-BNP).

Condition Swimming Induced Pulmonary Edema (SIPE), Pulmonary Edema, Lung Diseases, Heart Function Tests
Treatment Echocardiography, Electrocardiogram (ECG), Cardiac biomarkers, Cardiac biomarkers
Clinical Study IdentifierNCT05391737
SponsorDalarna County Council, Sweden
Last Modified on4 October 2022


Yes No Not Sure

Inclusion Criteria

for patients
respiratory symptoms during or after swimming at the Vansbrosimningen open water swimming event
diagnosis SIPE by signs of pulmonary edema on lung ultrasound
peripheral oxygen saturation ≤95%
for controls
completion of a swimming race of the Vansbrosimningen open water swimming event
no respiratory symptoms during or after swimming
no signs of pulmonary edema on lung ultrasound
matched to patients with SIPE regarding sex and age

Exclusion Criteria

declined consent
hemodynamic instability or decreased consciousness
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