Introduction. Family physicians have more opportunities to attend athletic competitions as medical staff at
first-aid centers because of the increasing popularity of endurance sports. Case. A 38-year-old man who participated in a triathlon race experienced difficulty in breathing after swimming and was moved to a
first-aid center. His initial oxygen saturation was 82% and a thoracic computed tomography scan showed bilateral ground glass opacity in the peripheral lungs. His diagnosis was noncardiogenic
pulmonary edema associated with exercise or swimming: exercise-induced
pulmonary edema (EIPE) or swimming-induced
pulmonary edema (SIPE). Treatment with
furosemide and
corticosteroid relieved his symptoms of
pulmonary edema. Discussion. Noncardiogenic
pulmonary edema associated with endurance sports is not common, but knowledge about EIPE/SIPE or neurogenic
pulmonary edema associated with
hyponatremia, which is called Ayus-Arieff syndrome, is crucial. Knowledge and caution for possible risk factors, such as exposure to cold water or
overhydration, are essential for both medical staff and endurance athletes. Conclusion. To determine the presence of
pulmonary edema associated with strenuous exercise, oxygen saturation should be used as a screening tool at a
first-aid center. To avoid risks for EIPE/SIPE, knowledge about these diseases is essential for medical staff and for athletes who perform extreme exercise.