Pulmonary edema associated with swimming and breath holding has been reported in the literature.1–4  Researchers generally agree that the mechanism responsible for the presenting symptoms of cough, hemoptysis, and dyspnea is pulmonary edema, which is caused, in part, by inspiration against a closed glottis. Less clear is the reason for pulmonary edema in the face of breath holding.

A female adolescent patient was admitted to the pediatric intensive care unit (PICU) following swimming practice, which involved breath-holding anaerobic drills that she had done many times. During one of the drills, the patient was noted to be underwater and had to be rescued. She was conscious following removal from the pool and remembered blacking out. The adolescent did not require cardiopulmonary resuscitation and had no traumatic injuries. She complained of shortness of breath and coughed up pink, frothy secretions. The patient...

You do not currently have access to this content.