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exercise exertion collapse

Robert C Oh, Bryan Malave, Justin D Chaltry
Exertional heat illness and exercise-associated hyponatremia continue to be a problem in military and recreational events. Symptoms of hyponatremia can be mistaken for heat exhaustion or heat stroke. We describe three cases of symptomatic hyponatremia initially contributed to heat illnesses. The first soldier was a 31-yr-old female who "took a knee" at mile 6 of a 12-mile foot march. She had a core temperature of 100.9°F, a serum sodium level of 129 mmol/L, and drank approximately 4.5 quarts of water in 2 h...
March 1, 2018: Military Medicine
Muhammad A Zafar, Aaron M Mulhall, William Eschenbacher, Ajay Kaul, Sadia Benzaquen, Ralph J Panos
BACKGROUND: Positive expiratory pressure(PEP) breathing modalities are commonly prescribed in obstructive lung diseases, however practical methods of airway pressures(AP) quantification for therapeutic efficacy are lacking. Excessive dynamic airway collapse(EDAC) is characterized by expiratory central airway collapse leading to dyspnea and poor quality of life(QoL), with limited therapeutic options. PURPOSE: To measure AP and exertional dyspnea in EDAC patients during normal breathing and with use of pursed-lip breathing(PLB), nasal PEP device(nPEP), and oral-PEP valve(oPEP) during rest and exercise using an Esophageal Manometer...
October 2017: Respiratory Medicine
Scott Anderson
Off-season training in year-round collegiate football is purported to be performance enhancing. Absent principles of exercise physiology, excesses in sport-training regimens pose risk to the participant athletes. Since 2000, 33 National Collegiate Athletic Association (NCAA) football players have died in sport: 27 nontraumatic deaths and 6 traumatic deaths, a ratio of 4.5 nontraumatic deaths for every traumatic death. On average, 2 NCAA football players die per season. Best practices, consensus guidelines, and precautions are ignored, elevating the risk...
February 2017: Journal of Athletic Training
Liliang Li, Yang Zhang, Allen Burke, Aimin Xue, Ziqin Zhao, David Fowler, Yiwen Shen, Ling Li
Causes of sudden cardiac deaths have been widely reported with limited data focused specifically on myocarditis. A retrospective review of cases from the Office of the Chief Medical Examiner (OCME), State of Maryland yielded a total of 103 sudden unexpected deaths (SUDs) due to myocarditis (0.17% of all SUDs and 0.70% of autopsied SUDs) from 2005 through 2014. Most deaths occurred in patients <30 years of age with a male:female ratio 1.3:1. Of the 103 cases, 45 (43.7%) patients were witnessed collapsed. Four deaths occurred during exertion, such as exercising at the gym or performing heavy physical work, and 2 deaths were associated with emotional stress...
March 2017: Forensic Science International
Daniel J Weinstein, James E Hull, Brittany L Ritchie, Jackie A Hayes, Michael J Morris
RATIONALE: Evaluation of military personnel for exertional dyspnea can present a diagnostic challenge, given multiple unique factors that include wide variation in military deployment. Initial consideration is given to common disorders such as asthma, exercise-induced bronchospasm, and inducible laryngeal obstruction. Excessive dynamic airway collapse has not been reported previously as a cause of dyspnea in these individuals. OBJECTIVES: To describe the clinical and imaging characteristics of military personnel with exertional dyspnea who were found to have excessive dynamic collapse of large airways during exercise...
September 2016: Annals of the American Thoracic Society
Mathias Poussel, Philippe Guerci, Pierre Kaminsky, Marie Heymonet, Nathalie Roux-Buisson, Julien Faure, Emilien Fronzaroli, Bruno Chenuel
OBJECTIVE: To describe the possible association (pathophysiologic and clinical features) between exertional heat stroke (EHS) and malignant hyperthermia (MH). BACKGROUND: Both EHS and MH are acute and life-threatening disorders. It has repeatedly been shown that EHS can occur in well-trained patients with known MH-associated mutation in the RYR1 gene in the absence of any extreme environmental conditions or extreme physical activity, thereby supporting a possible link between EHS and MH...
November 2015: Journal of Athletic Training
Camilla Slot Mehlum, Emil Schwarz Walsted, Christian Godballe, Vibeke Backer
Breathing difficulties during exertion may be caused by exercise-induced laryngeal obstruction (EILO). The diagnosis depends on visualization of the larynx during exercise, i.e. by continuous laryngoscopic exercise (CLE) test. In case of severe supraglottic collapse and pronounced symptoms during strenuous exertion, surgical treatment (supraglottoplasty) has been suggested. The aims of this study were to evaluate outcome and patient satisfaction after supraglottoplasty for EILO and to compare our results with previously reported data...
April 2016: European Archives of Oto-rhino-laryngology
Richard D Quattrone, E Randy Eichner, Anthony Beutler, W Bruce Adams, Francis G O'Connor
Sickle cell trait (SCT) has been associated with exertional collapse (ECAST) and exercise-related sudden death in athletes and military warfighters. The mechanisms underlying ECAST remain controversial in the sports medicine community. Multiple case presentations and anecdotal reports postulate the role of extraordinary exercise intensity, but other risk factors including dehydration, heat, previous exertional rhabdomyolysis, genetic cofactors, and dietary supplements have been cited as potential contributors...
March 2015: Current Sports Medicine Reports
Kevin A Fajardo, Juste Tchandja
In October 2011, a sickle cell trait (SCT)-positive Air Force recruit collapsed and died immediately following his physical fitness test. The cause of death was reported to be a cardiac dysrhythmia secondary to an acute sickling crisis. Although it is well known that SCT-positive individuals have a significant risk of exercise-related death (ERD), this case is notable in that none of the commonly cited risk factors were present, including exertional heat injury, dehydration, training at altitude, and rhabdomyolysis...
March 2015: Military Medicine
Morey A Blinder, Sarah Russel
Sickle cell trait (SCT) occurs in about 8% of African-Americans and is often described to be of little clinical consequence. Over time, a number of risks have emerged, and among these are rare but catastrophic episodes of sudden death in athletes and other individuals associated with physical activities which is often described as exercise collapse associated with sickle trait (ECAST). Despite an epidemiologic link between SCT and sudden death as well as numerous case reports in both medical literature and lay press, no clear understanding of the key pathophysiologic events has been identified...
November 19, 2014: Hematology Reports
Martin D Hoffman, Ian R Rogers, Jeremy Joslin, Chad A Asplund, William O Roberts, Benjamin D Levine
Increasing participation in ultramarathons and other ultra-endurance events amplifies the potential for serious medical issues during and immediately following these competitions. Since these events are often located in remote settings where access may be extremely limited; the diagnostic capabilities, treatment options, and expectations of medical care may differ from those of urban events. This work outlines a process for assessment and treatment of athletes presenting for medical attention in remote environments, with a focus on potentially serious conditions such as major trauma, acute coronary syndrome, exertional heat stroke, hypothermia, hypoglycemia, exercise-associated hyponatremic encephalopathy, severe dehydration, altitude illness, envenomation, anaphylaxis, and bronchospasm...
February 2015: Sports Medicine
Andrew W Nichols
Exertional heat-related illness (EHRI) is comprised of several states that afflict physically active persons when exercising during conditions of high environmental heat stress. Certain forms of EHRI may become life threatening if not treated. Exertional heat stroke (EHS), characterized by a core body temperature of >40 ° C and mental status changes, is the most severe form of EHRI. EHS must be treated immediately with rapid body cooling to reduce morbidity and mortality. Many EHRI cases are preventable by following heat acclimatization guidelines, modifying sports and exercise sessions during conditions of high environmental heat stress, maintaining adequate hydration, avoiding exertion in the heat when ill, and by educating sports medicine personnel, coaches, parents, and athletes on the early recognition and prevention of EHRI...
December 2014: Current Reviews in Musculoskeletal Medicine
Evan C Johnson, Fred W Kolkhorst, Allen Richburg, Andy Schmitz, John Martinez, Lawrence E Armstrong
A triathlete collapsed with exertional heatstroke (EHS) during 2 races over 3 months. The American College of Sports Medicine recommends a heat tolerance test (HTT) following EHS if there is a concern with return to play. The classical walking HTT may not be the best test to evaluate elite triathletes' heat tolerance due to race intensity, nor is it suited to evaluate acclimation ability, which may play a role in risk of heat illness. Is the athlete capable of returning to racing or should he retire from sport due to heat intolerance? Up to 90 min of cycling (70% of V˙O2max; 36°C, 50% relative humidity) was followed by 9 d of exercise heat acclimation and a final identical exercise heat stress test...
March 2013: Current Sports Medicine Reports
A L Nguyen, F Haas, J Evens, J M P J Breur
Anomalous aortic origin of the coronary artery from the opposite sinus with interarterial course (AAOCA) is a rare condition with a high risk of sudden cardiac death (SCD) during or after strenuous exertion. SCD after repair of this anomaly is extremely rare. Here we present a 15-year-old athlete who collapsed on the basketball court in whom an anomalous origin of the left coronary artery from the right sinus of Valsalva with interarterial course (ALCA) was diagnosed. In spite of extensive pre-sport participation testing, SCD occurred shortly after surgical correction...
November 2012: Netherlands Heart Journal
W Ketata, W K Rekik, H Ayadi, S Kammoun
The respiratory system undergoes progressive involution with age, resulting in anatomical and functional changes that are exerted on all levels. The rib cage stiffens and respiratory muscles weaken. Distal bronchioles have reduced diameter and tend to be collapsed. Mobilized lung volumes decrease with age while residual volume increases. Gas exchanges are modified with a linear decrease of PaO(2) up to the age of 70 years and a decreased diffusing capacity of carbon monoxide. Ventilatory responses to hypercapnia, hypoxia and exercise decrease in the elderly...
October 2012: Revue de Pneumologie Clinique
Francis G O'Connor, Michael F Bergeron, Joyce Cantrell, Philippe Connes, Kimberly G Harmon, Edward Ivy, John Kark, Dave Klossner, Peter Lisman, Bryce K Meyers, Karen O'Brien, Kwaku Ohene-Frempong, Alexis A Thompson, James Whitehead, Patricia A Deuster
INTRODUCTION: An estimated 300 million people worldwide have sickle cell trait (SCT). Although largely benign, SCT has been associated with exertional rhabdomyolysis and exercise-related sudden death in warfighters/athletes (WA). The National Collegiate Athletic Association's policy to confirm a student athlete's SCT status during their preparticipation medical examination prompted reaction from some organizations regarding the rationale and ethical justification of the policy. METHODS: On September 26 and 27, 2011, a summit, composed of military and civilian experts in sports medicine and SCT, was convened at the Uniformed Services University in Bethesda, MD...
November 2012: Medicine and Science in Sports and Exercise
Gregory R Dion, Robert L Eller, Roy F Thomas
OBJECTIVE: Laryngomalacia is best known as a self-resolving infantile disorder characterized by inspiratory stridor with occlusion of the larynx by collapse of arytenoid tissues due to Bernoulli forces. Adult laryngomalacia has been sporadically described in the literature. We identified a series of patients with aerodynamic supraglottic collapse mimicking laryngomalacia in our Otolaryngology clinic. STUDY DESIGN: Case series. METHODS/PATIENTS: A series of five patients from our Otolaryngology clinic with aerodynamic supraglottic collapse presented with complaints ranging from noisy breathing to dyspnea with exertion...
November 2012: Journal of Voice: Official Journal of the Voice Foundation
Taro Shimizu, Yasuharu Tokuda
A 23-year-old man presented with acute flushing, pruritus and warmth followed by collapse after vigorous exercise in a gymnasium. After resting for 30 min and receiving a rapid infusion of 0.9% sodium chloride, he was finally stable. He admitted that he had a similar experience 5 years earlier during exercise. Based on the patient's history, his symptoms were attributed to exercise-induced anaphylaxis. None of his episodes was associated with any suspicious co-triggers of anaphylaxis. He was successfully discharged from hospital without any complications after receiving guidance on how to prevent this condition...
May 30, 2012: BMJ Case Reports
Daniele Torres, Gaspare Parrinello, Mauro Cardillo, Marina Pomilla, Caterina Trapanese, Bellanca Michele, Umberto Lupo, Caterina Schimmenti, Francesco Cuttitta, Rossella Pietrantoni, Danai Vogiatzis, Giuseppe Licata
Hiatal hernia (HH) is a frequent entity. Rarely, it may exert a wide spectrum of clinical presentations mimicking acute cardiovascular events such as angina-like chest pain until manifestations of cardiac compression that can include postprandial syncope, exercise intolerance, respiratory function, recurrent acute heart failure, and hemodynamic collapse. A 69-year-old woman presented to the emergency department complaining of fatigue on exertion, cough, and episodes of restrosternal pain with less than 1 hour of duration...
November 2012: American Journal of Emergency Medicine
Jamie L Maciaszek, Biree Andemariam, Greg Huber, George Lykotrafitis
Collapse and sudden death in physical training are the most serious complications of sickle cell trait (SCT). There is evidence that erythrocytes in SCT patients aggregate during strenuous exercise, likely because of adhesive interactions with the extracellular matrix (ECM) and endothelial cells, and because of their irregular viscoelastic properties. This results in inflammation, blood flow impairment, and vaso-occlusive events. However, the exact role of stress conditions and how they lead to these complications is virtually unknown...
March 7, 2012: Biophysical Journal
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