Excessive water drinking during sporting events is sometimes encouraged openly by colleagues and tacitly by the drinks industry. This case highlights the risk of drinking more fluid than you actually need. A reviewer commented “The article makes some excellent points and is very well written. It is an important contribution in the continuing fight to insure that EAHE is properly treated by physicians who may not understand the role of fluid overload and SIADH in this condition and the need to treat all cases with hypertonic saline until the serum sodium concentration has normalized. Had this been followed in this case the athlete would have recovered very quickly.”

Pulmonary oedema and hyponatraemia after an ironman triathlon