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When does epistaxis appear with EIPH?
20 minutes after exercise but bleeding might be subclinical
What causes EPIH?
High capillary pressure in elite athletes
What is the pathophysiology of EIPH?
High pulmonary vascular pressures
Intrathoracic shear forces
Poor ventricular compliance
Coag dysfunction
Pulmonary inflammation
How do you treat EIPH?
Furosemide to reduce severity of bleeding
What are some alternate treatments for EIPH?
Proag agents
Antihypertensive drugs like enalapril or NO donors
Bronchodilators
Anti-inflammatories
How do you diagnose EIPH?
Endoscopy and BAL
What is the prognosis for EIPH?
Survival is favorable, but will continue to bleed with high performance