Finlay J B, Hartman A F, Weir R C
Department of Medical Biophysics, University of Western Ontario, London, Canada.
Med Sci Sports Exerc. 1995 Sep;27(9):1231-7.
Two swims (1993 and 1994) are described which led to post-swim orthostatic intolerance and one episode of syncope in a 50/51-yr-old well-trained and experienced marathon swimmer. The swims of 33 km and 38 km took 12 h 30 s and 17 h 35 min, respectively. Water temperature in each swim was above 23 degrees C and rectal core-temperature stayed above 37.0 degrees C. Air temperatures differed, ranging from 23 degrees to 37 degrees C and 15 degrees to 21 degrees C, respectively. Regular fluid consumption totalled approximately 5.0 and 6.0 1, respectively. Fifteen minutes after completing the 1993 swim, the swimmer experienced orthostatic intolerance and fainted at the lakeside; hospital tests revealed an elevated creatine phosphokinase (CK) of 521 U.l-1. The 1994 swim was abandoned due to severe muscle cramps and CK was found to be markedly elevated at 909 U.l-1. Orthostatic intolerance was recorded in both cases; however, no cardiac abnormalities were found. After overnight rest and intravenous saline infusions of 3.0 and 1.5 l, respectively, the orthostatic intolerance was relieved. Based on previous descriptions of exercise-associated collapse in marathon runners, the swimmer's orthostatic intolerance and syncope are attributed to blood pooling in his legs due to inactivation of the venous muscle pump on completion of the swim.
本文描述了一名50/51岁训练有素且经验丰富的马拉松游泳运动员在两次游泳（分别在1993年和1994年）后出现游泳后体位性不耐受以及一次晕厥发作的情况。两次游泳的距离分别为33公里和38公里，耗时分别为12小时30秒和17小时35分钟。每次游泳时水温均高于23摄氏度，直肠核心温度保持在37.0摄氏度以上。两次游泳时的气温不同，分别为23摄氏度至37摄氏度和15摄氏度至21摄氏度。常规液体摄入量总计分别约为5.0升和6.0升。在完成1993年的游泳后15分钟，该游泳运动员出现体位性不耐受并在湖边晕倒；医院检查显示肌酸磷酸激酶（CK）升高至521 U.l-1。1994年的游泳因严重肌肉痉挛而中止，发现CK显著升高至909 U.l-1。两例均记录到体位性不耐受；然而，未发现心脏异常。经过一夜休息并分别静脉输注3.0升和1.5升生理盐水后，体位性不耐受症状得到缓解。基于之前对马拉松运动员运动相关虚脱的描述，该游泳运动员的体位性不耐受和晕厥归因于游泳结束后静脉肌肉泵失活导致血液在其腿部积聚。
