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Delirium and pulmonary edema after completing a marathon
The American Review of Respiratory Disease
|September 1, 1987
Summary
Pulmonary edema is a rare complication of marathon running. This case in an untrained runner suggests a noncardiogenic cause, possibly neurogenic pulmonary edema from water intoxication.
Area of Science:
- Sports Medicine
- Cardiology
- Pulmonology
Background:
- Pulmonary edema is a rare but serious complication of endurance running.
- Previous cases were associated with triathlons or ultramarathons.
- This is the first reported case in a conventional marathon runner.
Purpose of the Study:
- To report the first case of pulmonary edema in a marathon runner with hemodynamic measurements.
- To investigate the potential noncardiogenic etiology of exercise-induced pulmonary edema.
Main Methods:
- Case report of a healthy, untrained marathon runner who developed pulmonary edema.
- Hemodynamic monitoring including pulmonary capillary wedge pressure and cardiac index.
- Assessment of arterial-venous oxygen tension difference.
- Evaluation for hyponatremia and cerebral edema.
Main Results:
- Pulmonary edema occurred after a 42-km marathon race.
- Hemodynamic measurements indicated predominantly noncardiogenic pulmonary edema.
- Low pulmonary capillary wedge pressure and initially depressed cardiac index.
- Arterial-venous oxygen tension difference normalized after volume infusion.
- Concurrent hyponatremia and cerebral edema were noted.
Conclusions:
- Exercise-induced pulmonary edema can occur in marathon runners, even if untrained.
- Hemodynamic data suggest a noncardiogenic mechanism.
- Neurogenic pulmonary edema secondary to water intoxication may be a contributing factor.