lcreswell wrote:
I think it's important to be very clear. Above, you asserted that SIPE was statistically more prevalent than heart problems in autopsies of triathlon swim death victims. That's simply not true.
I don't doubt that SIPE exists. That condition has been well-established and the accounts from our fellow triathletes that you mention are simply fascinating.
The piece from Dr. Dressendorfer is also interesting. But it's important to remember that this is an opinion piece. This isn't a study. This isn't presenting autopsy information from victims. The author's background is such that the article deserves our attention, though. It's most useful for the discussion about SIPE physiology.
Lastly, you questioned the data about arrhythmias. It is a fact that all but 2 of the swim fatality victims from 2003-2011 DID have a fatal arrhythmia when they were rescued from the water and the remaining 2 victims were found in asystole some time after the swim portion had ended.
I've learned in medicine, and with triathlon!, that anything is possible. And in that sense, SIPE may play a role in these deaths. But I'm very skeptical.
If you read my post above, you will see that I corrected myself and said that while I don't doubt arrhythmia is the leading cause, I question WHY they occur in the first place.
A V/Q mismatch will cause physiological problems including arrhythmias, pulmonary edema. The bigger question I have is WHY do these people have these to begin with?
Are people developing SIPE in the water and due to the hypoxia going into an arrhythmia? You can't really study that because it isn't a place where you can just go and collect evidence to support the theory for the most part I would think.
The bottom line is that no one really knows. There is a complete lack of information as to why this occurs. At least on dry land (marathons) we have first responders that can work quicker and it is typically a more definitive answer.
Rather than trying to be right here, I am simply asking the questions. It's not like you can recreate the conditions in a lab and there is only so much information you can gain from an autopsy according to my training partner who is a pathologist. I think it is far too simple to just say "They died as a result of a refractory V-Fib"...no kidding....most people do. WHY did they die as a result of the V-Fib is the real concern.