Are Triathletes Really Dying of Heart Attacks During the Swim Portion of the Race? - Probably Not!

Our very excellent friend Dia sent us this.

Last week the sport of triathlon suffered another fatality during the swim portion of the Beach2Battleship race. 68-year-old Roger Ackerman was suddenly in distress. He alerted staff but soon after medical workers began administering CPR. Though Mr. Ackerman had a history of heart issues he had seemingly defeated those issues by becoming an endurance athlete who had run more than twenty, 100-mile races and was medically cleared to do the race.

When terrible events like this happen the primary suspect is a heart attack but why are fit people having heart attacks in an event they are seemingly well practiced for?

Brian Alexander has an article over at Outside Magazine exploring a phenomena called Swimmer Induce Pulmonary Edema (SIPE) which is when internal fluid enters the lungs:

There have been a number of SIPE reports over the past decade that back up MacIver’s and Bates’ suggestion. For example, during a training exercise, young Israeli special forces soldiers swam 2.4 kilometers. Of 30 soldiers who started the swim, 8 showed signs of fluid in the lungs, edema.

Unfortunately, nobody is sure just why this happens.

[Link]

How frequent in the triathlon population is this problem?

From Hindawi Pulmonary Journal

"... Exercise in water places a unique set of stresses on the respiratory system. Immersion pulmonary edema with breath-hold diving, SCUBA diving, and cold water exercise has been well documented in the literature [39–41]. In a survey of 460 active SCUBA divers, 1.1% had a history consistent with the development of immersion pulmonary edema [42].  

A survey of triathletes from the group USA Triathlon revealed that 1.4% of the members had symptoms suggestive of pulmonary edema after completing an event that contained a swimming component... [43] 

[Link]

I am going to finish off with immediate symtoms of SIPE which are listed in the Outside Magazine article:

"...MacIver listed warning signs of edema, like frothy or pink sputum and excessive breathlessness out of proportion with the normal heavy breathing of intense exercise. ..."

A good athlete knows when to quit, be a good athlete. Be prepared and injury is never fun death is forever.