Swim Induced Pulmonary Edema
Swim Induced Pulmonary Edema Pulmonary edema is a condition characterized by an accumulation of fluid in the lungs, which can cause significant breathing difficulties and pose serious health risks. However, when pulmonary edema occurs specifically due to swimming or engaging in water-related activities, it is referred to as swim induced pulmonary edema (SIPE).
Whether you have experienced swim induced pulmonary edema before or are interested in learning more about this condition, this guide will equip you with the knowledge and resources needed to stay informed and protect your lung health. By understanding the potential breathing issues that can arise from swim induced pulmonary edema, you can take the necessary steps to prevent its occurrence and enjoy your aquatic activities to the fullest.
So, let’s dive in and explore the world of swim induced pulmonary edema, its impact on swimmers, and the best practices to keep yourself safe and healthy while participating in water sports and activities.
Understanding Pulmonary Edema
Pulmonary edema is a condition that can occur in swimmers and individuals engaged in water-related activities. It refers to the accumulation of fluid in the lungs, leading to water-related lung problems. Swim induced pulmonary edema is a specific type of pulmonary edema that occurs during or immediately after swimming.
The causes of pulmonary edema in swimmers can vary, but it is often associated with increased hydrostatic pressure in the pulmonary capillaries due to immersion in water. This can result in an imbalance of fluid movement in the lungs, causing fluid to leak into the air sacs. The mechanism by which swim induced pulmonary edema occurs is complex and involves factors such as increased blood flow to the lungs, elevated pulmonary artery pressure, and increased pulmonary capillary permeability.
Swim induced pulmonary edema can present with symptoms such as shortness of breath, coughing, chest tightness, and frothy or blood-tinged sputum. These symptoms may be mistaken for other respiratory issues, making it essential to recognize the specific signs of swim induced pulmonary edema and differentiate it from other conditions.
To better understand swim induced pulmonary edema and its intricacies, it is important to be aware of the risk factors, signs, and symptoms associated with this condition. By gaining a deeper understanding of its causes and mechanisms, swimmers can take preventive measures to reduce the risk of swim induced pulmonary edema and protect their respiratory health.
Main Causes of Swim Induced Pulmonary Edema:
- Increased hydrostatic pressure in the pulmonary capillaries
- Elevated blood flow to the lungs
- Elevated pulmonary artery pressure
- Increased pulmonary capillary permeability
Common Symptoms of Swim Induced Pulmonary Edema:
- Shortness of breath
- Coughing
- Chest tightness
- Frothy or blood-tinged sputum
Gaining a comprehensive understanding of swim induced pulmonary edema is crucial for swimmers and individuals engaged in water-related activities. By recognizing the causes and mechanisms of this condition, individuals can take the necessary precautions to minimize the risk of pulmonary edema in swimmers and ensure a safe and enjoyable aquatic experience.
Pulmonary Edema Type | Causes | Symptoms |
---|---|---|
Swim Induced Pulmonary Edema | Increased hydrostatic pressure, elevated blood flow to the lungs, elevated pulmonary artery pressure, increased pulmonary capillary permeability | Shortness of breath, coughing, chest tightness, frothy or blood-tinged sputum |
Non-Swim Related Pulmonary Edema | Cardiac issues, high altitude, infections, exposure to toxins | Shortness of breath, difficulty breathing, coughing, fatigue, chest discomfort |
Risk Factors for Swim Induced Pulmonary Edema
Swimming and other aquatic activities offer numerous health benefits, but they also come with potential risks. Understanding the risk factors associated with swim induced pulmonary edema (SIPE) is essential for swimmers and water sports enthusiasts to prioritize their well-being and safety.
Swimming health risks: Various medical conditions can increase the susceptibility to swim induced pulmonary edema. Individuals with pre-existing cardiovascular issues, such as high blood pressure and heart disease, should exercise caution while engaging in aquatic activities. These conditions can affect the heart’s ability to pump blood efficiently, contributing to the development of SIPE.
Aquatic activity lung issues: Swimmers who frequently expose themselves to cold water environments or engage in strenuous water sports may be at a higher risk of developing swim induced pulmonary edema. Cold water can constrict blood vessels and impair lung function, while intense physical exertion can lead to increased blood flow to the lungs, potentially triggering SIPE.
Swim induced pulmonary edema: Individual factors can also play a role in increasing the likelihood of swim induced pulmonary edema. Inexperienced swimmers or those who push themselves beyond their physical limits without proper training and conditioning are more susceptible to this condition. Additionally, inadequate recovery time between swimming sessions may also contribute to the development of SIPE.
Factors contributing to swim induced pulmonary edema:
- Pre-existing medical conditions such as high blood pressure and heart disease
- Exposure to cold water environments
- Engaging in strenuous water sports
- Inexperience and lack of proper training
- Inadequate recovery time between swimming sessions
By understanding these risk factors, individuals can make informed decisions about their aquatic activities, take necessary precautions, and seek appropriate medical advice to minimize the chances of swim induced pulmonary edema.
Risk Factors | Description |
---|---|
Pre-existing medical conditions | Individuals with conditions like high blood pressure and heart disease have an increased risk of developing swim induced pulmonary edema. |
Exposure to cold water environments | Swimmers who frequently immerse themselves in cold water may experience constriction of blood vessels and impaired lung function, increasing the susceptibility to SIPE. |
Engaging in strenuous water sports | Intense physical activity and increased blood flow to the lungs during water sports can potentially trigger swim induced pulmonary edema. |
Inexperience and lack of proper training | Swimmers with insufficient training or those who exceed their physical limits without adequate preparation are more prone to developing SIPE. |
Inadequate recovery time between swimming sessions | Insufficient rest between swimming sessions can contribute to the development of swim induced pulmonary edema. |
Signs and Symptoms of Swim Induced Pulmonary Edema
Recognizing the signs and symptoms of swim induced pulmonary edema (SIPE) is essential for prompt intervention and prevention of further complications. Whether you are an avid swimmer or engage in water sports, being aware of these indicators can make a significant difference in safeguarding your health. Here are the common signs and symptoms to watch out for:
- Shortness of breath: One of the primary indications of SIPE is experiencing difficulty breathing or feeling breathless while swimming or shortly after water-related activities.
- Coughing: Persistent coughing, especially accompanied by a frothy or pinkish sputum, could be a sign of fluid accumulating in the lungs.
- Chest pain or discomfort: SIPE may result in chest pain or discomfort, which can range from mild to severe. It is essential not to ignore any unusual sensations in the chest while swimming or engaging in aquatic activities.
- Rapid breathing: If you find yourself suddenly breathing faster than normal, even when at rest, it could be an indication of swim induced pulmonary edema.
- Fatigue or weakness: Feeling excessively tired or weak during or after swimming could be a symptom of SIPE.
- Anxiety or confusion: In some cases, swim induced pulmonary edema may lead to feelings of anxiety or confusion due to decreased levels of oxygen in the body.
- Dizziness or lightheadedness: If you experience sudden bouts of dizziness or lightheadedness while in the water, it is essential to take it seriously and seek medical attention.
If you or someone you know is experiencing any of these symptoms during or after swimming, immediate action should be taken. Promptly remove yourself or the affected individual from the water, and seek medical assistance without delay. It is crucial to remember that swim induced pulmonary edema can worsen rapidly, leading to life-threatening situations if not properly addressed.
In the next section, we will explore the various diagnostic methods and treatment options available to manage swim induced pulmonary edema effectively.
Signs and Symptoms | Description |
---|---|
Shortness of breath | Difficulty breathing or feeling breathless during or after swimming. |
Coughing | Persistent cough, often accompanied by frothy or pinkish sputum. |
Chest pain or discomfort | Mild to severe pain or discomfort in the chest area. |
Rapid breathing | Increased breathing rate even when at rest. |
Fatigue or weakness | Feeling excessively tired or weak during or after swimming. |
Anxiety or confusion | Feelings of anxiety or confusion due to decreased oxygen levels. |
Dizziness or lightheadedness | Sudden bouts of dizziness or lightheadedness while in the water. |
Diagnosis and Treatment Options
Diagnosing swim induced pulmonary edema (SIPE) involves a careful evaluation of the individual’s symptoms, medical history, and potential risk factors. Healthcare professionals may use various diagnostic procedures to confirm the presence of swim induced pulmonary edema and rule out other respiratory conditions.
Diagnostic Procedures
Common diagnostic procedures used for swim induced pulmonary edema include:
- Clinical Evaluation: The healthcare provider will assess the individual’s symptoms, medical history, and exposure to water-related activities.
- Chest X-Ray: X-ray images of the chest can help identify signs of fluid accumulation in the lungs, a common characteristic of swim induced pulmonary edema.
- Echocardiogram: An echocardiogram uses sound waves to create real-time images of the heart and examine its structure and function. It can help detect any abnormalities that may contribute to pulmonary edema.
- Pulmonary Function Tests: These tests measure lung capacity and function to assess respiratory health and identify any underlying lung conditions.
- Blood Tests: Blood tests can help evaluate oxygen levels and assess any abnormalities in blood chemistry, which can provide valuable insights into the individual’s overall health.
Treatment Options
Once swim induced pulmonary edema is diagnosed, appropriate treatment options can be recommended. Treatment approaches for swim induced pulmonary edema may include:
- Immediate Measures: If an individual experiences acute respiratory distress during swimming or water-related activities, it is essential to prompt them to cease activity, exit the water, and seek medical attention as soon as possible.
- Medical Interventions: Healthcare professionals may prescribe medications to alleviate symptoms and manage underlying conditions that contribute to swim induced pulmonary edema. These may include diuretics to remove excess fluid from the body and medications to reduce pulmonary inflammation.
- Lifestyle Modifications: Making certain lifestyle changes can help manage swim induced pulmonary edema. These may include avoiding strenuous exercise in cold water, maintaining optimal cardiovascular health through regular exercise and a balanced diet, and staying well-hydrated.
It is crucial for individuals diagnosed with swim induced pulmonary edema to consult with their healthcare provider to determine the most appropriate treatment plan tailored to their specific needs and circumstances.
Treatment Options | Advantages | Considerations |
---|---|---|
Immediate Measures | – Promptly stops activity and seeks medical attention – Can prevent further complications |
– Reliance on external help – Emergency situation management |
Medical Interventions | – Alleviates symptoms – Manages underlying conditions – Facilitates recovery |
– Requires proper diagnosis – Medication adherence – Potential side effects |
Lifestyle Modifications | – Promotes overall cardiovascular health and well-being – Reduces recurrent episodes |
– Requires commitment and discipline – Individual adherence may vary |
Prevention Strategies for Swim Induced Pulmonary Edema
Swim induced pulmonary edema (SIPE) is a serious condition that can occur during aquatic exercise and poses risks to swimmers. By implementing effective prevention strategies, individuals can reduce the likelihood of developing swim-induced breathing issues and other complications. Here are some practical tips to stay safe while engaging in aquatic activities:
1. Gradually Increase Intensity
When starting a new aquatic exercise routine, it’s crucial to gradually increase intensity and duration. Pushing yourself too hard, too quickly can increase the risk of swim induced pulmonary edema. Consult with a swimming coach or fitness professional to design a personalized training plan that suits your current fitness level and helps you progress safely.
2. Warm Up and Cool Down
Before diving into intense swimming sessions, make sure to warm up your body with light exercises and stretches. Warm-ups and cool-downs can help prepare your muscles for the physical demands of swimming and prevent sudden strain or stress on your respiratory system.
3. Maintain Proper Technique
Proper swimming technique is essential to minimize the strain on your body while in the water. Inefficient strokes, incorrect breathing patterns, and excessive strain can increase the risk of swim-induced breathing issues. Consider working with a swim coach to improve your technique and ensure that you’re performing each stroke correctly.
4. Be Mindful of Environmental Factors
Pay attention to the water temperature and current conditions before entering the water. Cold water, strong currents, and high waves can all contribute to swim induced pulmonary edema. Avoid swimming alone and always swim in designated areas where lifeguards are present.
5. Stay Hydrated
Hydration is vital during any physical activity, including swimming. Dehydration can lead to increased strain on the cardiovascular system and potentially trigger swim induced pulmonary edema. Drink plenty of water before, during, and after your swim sessions to maintain optimal hydration levels.
6. Monitor Your Body’s Signals
Pay attention to your body’s signals during aquatic exercise. If you experience any unusual symptoms, such as difficulty breathing, chest pain, or persistent coughing, it’s important to stop swimming and seek medical attention. Ignoring symptoms can exacerbate swim-induced breathing issues and lead to further complications.
7. Train in Safe Environments
Choose swimming venues that prioritize safety and cleanliness. Chlorine levels in pools should be properly regulated to prevent respiratory irritations. Open water swimming should only be undertaken in areas known for their water quality and where there are no known environmental hazards.
8. Know Your Limits
Be aware of your physical limitations and avoid exceeding them. Overexertion can increase the risk of swim induced pulmonary edema. Pay attention to your body’s signals of fatigue, and take breaks as needed to rest and recover.
9. Seek Medical Advice
If you have a history of respiratory conditions or other underlying medical issues, consult with a healthcare professional before engaging in aquatic exercise. They can provide personalized guidance and recommendations to ensure your safety while swimming.
Prevention Strategies | Details |
---|---|
Gradually Increase Intensity | Consult with a swimming coach or fitness professional to design a personalized training plan. |
Warm Up and Cool Down | Perform light exercises and stretches before and after swimming sessions to prepare and recover your muscles. |
Maintain Proper Technique | Work with a swim coach to improve your swimming technique and stroke form. |
Be Mindful of Environmental Factors | Avoid swimming in cold water, strong currents, and high waves. Swim in designated areas with lifeguards. |
Stay Hydrated | Drink plenty of water before, during, and after swimming to maintain optimal hydration levels. |
Monitor Your Body’s Signals | Pay attention to any unusual symptoms during swimming, such as difficulty breathing or chest pain. Seek medical attention if needed. |
Train in Safe Environments | Choose swimming venues with well-regulated chlorine levels in pools, or open water areas known for their water quality. |
Know Your Limits | Avoid overexertion and listen to your body’s signals of fatigue. Take breaks as needed. |
Seek Medical Advice | Consult with a healthcare professional if you have pre-existing respiratory conditions or medical issues. |
Training and Conditioning for Swimmers
Proper training and conditioning are crucial for swimmers to minimize the risk of swim-induced pulmonary edema (SIPE) and ensure overall swimming health. By building endurance, managing fatigue, and improving cardiovascular health, swimmers can enhance their performance while reducing the likelihood of developing this condition.
Building Endurance
Endurance training plays a vital role in preparing swimmers for the demands of rigorous aquatic activities. It involves gradually increasing the duration and intensity of swim sessions to improve cardiovascular fitness. This type of training not only enhances endurance but also strengthens the respiratory muscles, improving breathing efficiency, and reducing the risk of swim-induced breathing issues.
Managing Fatigue
Swimming for extended periods can lead to fatigue, which can increase the susceptibility to swim-induced pulmonary edema. Proper rest and recovery are essential to prevent overexertion and reduce the risk of developing this condition. Swimmers should listen to their bodies, take regular breaks, and incorporate rest days into their training regimen to allow for muscle repair and replenishment of energy stores.
Improving Cardiovascular Health
A robust cardiovascular system is crucial for swimmers to excel in their sport and safeguard against swimming health risks. Engaging in activities that improve cardiovascular fitness outside of the pool, such as running, cycling, or aerobic exercises, helps strengthen the heart and lungs. Additionally, cross-training with exercises like weightlifting or yoga can enhance overall muscular strength, stability, and flexibility, further supporting a swimmer’s performance and reducing the likelihood of swim-induced pulmonary edema.
By incorporating proper training techniques and conditioning exercises into their routine, swimmers can minimize the risks associated with swim-induced pulmonary edema and enhance their overall swimming performance and health.
Safety Measures in Water Sports
When engaging in water sports, it is crucial to prioritize safety to prevent swim induced pulmonary edema and other medical conditions. By following these safety measures, swimmers and aquatic athletes can enjoy their activities while minimizing the risk of health complications.
Adequate Supervision
Never swim alone. Always ensure that there is someone present who can provide immediate assistance in case of an emergency. Swimming in groups or under the watchful eye of a certified lifeguard can significantly enhance safety during water sports.
Proper Equipment Usage
Wear appropriate safety gear and equipment while participating in water sports activities. This may include life jackets, helmets, goggles, and wetsuits, depending on the specific sport. Properly fitting and certified equipment can provide added protection and minimize the risk of injury or complications.
Understanding Water Conditions
Before entering the water, be aware of the prevailing conditions. Factors such as water temperature, currents, tides, and weather conditions can significantly impact the safety of water sports activities. Stay informed through reliable sources and be prepared to adjust plans or activities accordingly.
Training and Education
Receive appropriate training and education in the specific water sport or activity you are participating in. Understanding the proper techniques, guidelines, and safety protocols can help prevent accidents and reduce the risk of swim induced pulmonary edema and other medical conditions.
Stay Hydrated
Dehydration can increase the risk of medical emergencies during water sports. Ensure that you are well-hydrated before, during, and after your activities. Drink plenty of water and avoid excessive caffeine or alcohol intake, as they can contribute to dehydration.
Schedule Regular Breaks
Avoid overexertion and schedule regular breaks during your water sports activities. Prolonged periods of intense activity can lead to fatigue and increase the risk of health complications. Listen to your body and take breaks as needed.
By implementing these safety measures, swimmers and aquatic athletes can protect themselves and minimize the risk of swim induced pulmonary edema and other medical conditions. Remember, prevention is key, and prioritizing safety ensures a enjoyable and safe experience in the water.
Related Medical Conditions and Compatibility with Aquatic Activities
While swim induced pulmonary edema (SIPE) is a significant concern for individuals engaging in water sports, there are also other medical conditions that can affect a person’s compatibility with aquatic activities. It’s essential to be aware of these conditions and understand how they can increase the risk of developing swim induced pulmonary edema.
Potential Medical Conditions Affecting Aquatic Activity
Various medical conditions can pose challenges for individuals participating in water sports. These conditions may impact lung function, cardiovascular health, or overall physical well-being, making them a potential risk factor for swim induced pulmonary edema. Some of the medical conditions associated with increased vulnerability include:
- Chronic obstructive pulmonary disease (COPD)
- Asthma and other respiratory disorders
- Cardiac conditions such as heart failure or arrhythmias
- High blood pressure (hypertension)
- Diabetes
- Obesity
- Smoking-related lung diseases
- Allergies
Medical Condition | Risk Factor for SIPE |
---|---|
Chronic obstructive pulmonary disease (COPD) | Increases the risk of pulmonary edema during water sports due to compromised lung function. |
Asthma and other respiratory disorders | Individuals with asthma or other respiratory conditions have a higher susceptibility to swim induced pulmonary edema due to potential breathing difficulties. |
Cardiac conditions | Heart-related conditions can lead to cardiovascular strain during aquatic activities, potentially triggering swim induced pulmonary edema. |
High blood pressure (hypertension) | Hypertension can contribute to increased fluid retention, putting individuals at a higher risk of swim induced pulmonary edema. |
Diabetes | Individuals with diabetes may experience poor circulation and impaired oxygen exchange, making them more susceptible to swim induced pulmonary edema. |
It’s important for individuals with these medical conditions to consult with healthcare professionals, such as the experts at Acibadem Healthcare Group, before engaging in aquatic activities. Through proper evaluation and guidance, individuals can understand their specific risks and take appropriate measures to ensure their safety.
By recognizing the potential impact of other medical conditions on swim induced pulmonary edema, individuals can make informed decisions regarding their participation in water sports and implement necessary precautions to minimize risks.
Post-Swim Care and Recovery
After experiencing or being at risk of swim induced pulmonary edema, it is crucial to prioritize post-swim care and recovery. These recommended practices promote healing and help prevent future incidents, ensuring swimmers’ overall well-being.
1. Monitor Symptoms:
Pay close attention to any lingering symptoms or new signs of discomfort. If you experience shortness of breath, coughing, chest pain, or excessive fatigue after swimming, seek medical attention promptly.
2. Rest and Hydrate:
Allow your body ample time to rest and recover from the physical stress of swimming. Adequate hydration is also essential in maintaining optimal lung function and overall health.
3. Follow Medical Advice:
Adhere to the instructions and recommendations provided by your healthcare professionals. They will guide you on any necessary medications, lifestyle modifications, or specialized treatments to support your recovery.
4. Gradual Return to Swimming:
Once you have fully recovered, gradually reintroduce swimming into your routine. Begin with low-intensity sessions and increase the duration and intensity gradually. Listen to your body and adjust accordingly.
5. Strengthening Exercises:
Engaging in targeted exercises can help improve lung capacity, cardiovascular endurance, and overall strength. Consult with a qualified trainer or physical therapist to establish an appropriate exercise regimen.
6. Avoid Overexertion:
Be mindful not to push yourself too hard or engage in strenuous activities beyond your current fitness level. Overexertion can increase the risk of swim induced pulmonary edema. Always respect your body’s limitations.
7. Maintain a Healthy Lifestyle:
Adopting a healthy lifestyle can help reduce the chances of experiencing swim induced pulmonary edema. Eat a balanced diet, get regular exercise, manage stress levels, and avoid smoking or exposure to secondhand smoke.
8. Regular Check-ups:
Stay proactive about your health by scheduling regular check-ups with your healthcare provider. This allows for ongoing monitoring of your lung function and overall well-being.
By following these post-swim care and recovery practices, swimmers can minimize the risk of swim induced pulmonary edema and enjoy aquatic activities safely. Remember to prioritize your health and seek medical assistance when needed.
Mental Preparedness and Support
Dealing with swim induced pulmonary edema can be a challenging and overwhelming experience, both physically and mentally. Alongside physical care, it is essential to prioritize your mental well-being and seek the necessary support to navigate through this condition.
Emotional Support
Swim induced pulmonary edema can have a significant impact on one’s emotional state. It is crucial to reach out to friends, family, or support groups who can provide understanding, empathy, and a listening ear. Sharing your feelings and experiences can help alleviate stress and anxiety, allowing you to feel more supported throughout your journey.
Managing Anxiety
Living with swim induced pulmonary edema might lead to heightened anxiety and worries about future swimming or water-related activities. Consider exploring techniques such as deep breathing exercises, mindfulness, or meditation to help calm your mind and reduce anxiety levels. Remember that managing anxiety is a process, and it’s okay to seek professional help or consult with a healthcare provider if needed.
Positive Mindset
Developing a positive mindset can play a crucial role in coping with swim induced pulmonary edema. Focusing on your strengths, setting achievable goals, and celebrating small victories can help shift your mindset from dwelling on the challenges to embracing the resilience and determination within you. Surround yourself with positive influences, engage in activities you enjoy, and remind yourself that you are not defined by your condition.
Professional Guidance
Don’t hesitate to seek professional guidance from mental health professionals, such as therapists or counselors, who specialize in supporting individuals with chronic health conditions. They can provide unique insights, coping strategies, and personalized support tailored to your specific needs. Having a professional on your side can empower you on your journey towards mental well-being.
Support Communities
Engaging with support communities or online forums for individuals with swim induced pulmonary edema can also be beneficial. Connecting with others who face similar challenges can provide a sense of belonging, validation, and a platform to share experiences, tips, and resources. Remember, you are not alone, and support is available.
By prioritizing your mental well-being and seeking the necessary support, you can better navigate the emotional aspects of swim induced pulmonary edema, empowering yourself to live a fulfilling life while managing this condition.
Conclusion
Swim induced pulmonary edema (SIPE) is a serious condition that can result in breathing difficulties and potential harm to swimmers. Throughout this article, we have explored the risks, symptoms, diagnosis, treatment options, and prevention strategies for swim induced pulmonary edema.
It is crucial to be aware of the signs and symptoms of this condition and to seek medical attention promptly if necessary. By understanding the risk factors and taking preventative measures, individuals can significantly reduce the likelihood of developing swim induced pulmonary edema.
As a leader in healthcare, Acibadem Healthcare Group is committed to providing specialized care and support for individuals affected by swim induced pulmonary edema. Their expertise and dedication play a vital role in promoting awareness, diagnosis, and effective treatment of this condition.
Remember, by staying informed and taking the necessary precautions, swimmers can enjoy the water safely and minimize the risks associated with swim induced pulmonary edema.
FAQ
What is swim induced pulmonary edema?
Swim induced pulmonary edema, also known as SIPE, is a condition where fluid accumulates in the lungs during or immediately after swimming or other water-related activities. This can cause difficulty in breathing and may lead to respiratory distress.
What are the symptoms of swim induced pulmonary edema?
Symptoms of swim induced pulmonary edema may include coughing, wheezing, shortness of breath, chest pain, fatigue, and a frothy or pinkish sputum. These symptoms typically occur during or after swimming and should not be ignored.
What are the risk factors for swim induced pulmonary edema?
Several factors can increase the risk of swim induced pulmonary edema, including pre-existing medical conditions such as high blood pressure, heart disease, or asthma. Other risk factors may include cold water exposure, intense exercise, and swimming at high altitudes.