Hyponatremia and pulmonary oedema during ironman triathlon

Stefanko, G., Lancashire, B., Coombes, J. and Fassett, R. (2009). Hyponatremia and pulmonary oedema during ironman triathlon. In: C. Finch, Journal of Science and Medicine in Sport: Program and Abstracts - be active '09. 'be active '09' - 2009 Australian Conference of Science and Medicine in Sport, Brisbane, Qld, Australia, (e99-e99). 14-17 October, 2009. doi:10.1016/j.jsams.2009.10.204


Author Stefanko, G.
Lancashire, B.
Coombes, J.
Fassett, R.
Title of paper Hyponatremia and pulmonary oedema during ironman triathlon
Formatted title


Conference name 'be active '09' - 2009 Australian Conference of Science and Medicine in Sport
Conference location Brisbane, Qld, Australia
Conference dates 14-17 October, 2009
Proceedings title Journal of Science and Medicine in Sport: Program and Abstracts - be active '09   Check publisher's open access policy
Place of Publication Amsterdam, The Netherlands
Publisher Elsevier
Publication Year 2009
DOI 10.1016/j.jsams.2009.10.204
ISSN 1440-2440
Editor C. Finch
Volume 12
Issue Suppl. 2
Start page e99
End page e99
Total pages 1
Language eng
Formatted Abstract/Summary
History:
36-Year-old male had chest tightness, shortness of breath and cough productive of pink sputum at the conclusion of the Australian Ironman triathlon. Thirty hours after presentation the patient had a seizure.

Physical examination:

On arrival at hospital, the patient was alert and orientated, afebrile, pale and diaphoretic. The heart rate was 96 bpm in sinus rhythm, respiratory rate 32 bpm, BP 134/89, oxygen saturation 75% on room air and chest examination revealed bilateral basal crepitations.

Differential diagnosis:

Acute pulmonary edema, respiratory infection.

Tests/Results:

Chest X-ray showed diffuse bilateral pulmonary infiltrates, ECG normal, serum sodium 120 mmol/l, creatinine 60 μmol/l, creatinine kinase 5613 U/l, troponin I 0.27 μg/l, BNP 1950 pg/ml, Hb 142 g/l, WCC 20.5 × 109 /l, neutrophils 17.6x109/l. Arterial blood gases PO2 on BiPAP 247 mmHg, bicarbonate 21.1 mmol/l, lactate 1.5 mmol/l, urine sodium 101 mmol/l. Serum sodium fell to 117 mmol/l on day two. Echocardiogram suggested mild hypokinesis of inferior wall of the left ventricle. CT brain was normal. Subsequent coronary angiogram was normal.

Final working diagnosis:

Acute pulmonary edema, hyponatremia and seizure.

Treatment/outcomes:
Glyceryl trinitrate infusion, IVfrusemide and BiPAP, oral asprin 100 mg/d, clopidogrel 75 mg/d, captopril 25 mg three times/d, IV ceftriaxone and azithromycin. IV 200 ml of 3% saline infused over 30 min followed by normal saline. Patient fully recovered and was discharged 5 days after admission.


Subjects EX
110602 Exercise Physiology
110604 Sports Medicine
950102 Organised Sports
Q-Index Code EX
Q-Index Status Provisional Code

Document type: Conference Paper
Collection: School of Human Movement and Nutrition Sciences Publications
 
Versions
Version Filter Type
Citation counts: Google Scholar Search Google Scholar
Created: Sat, 13 Mar 2010, 17:52:51 EST by Deborah Noon on behalf of School of Human Movement and Nutrition Sciences