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Please Pass the Salt

Author: Katie Dolbec, MD, CAQ-SM
Peer-reviewer: Matthew Negaard, MD, CAQ-SM
Final Editor: Alex Tomesch, MD, CAQ-SM

A patient presents to the Emergency Department endorsing fatigue, malaise, nausea, and headache after completing his first marathon. It was a hot, humid day with a wet bulb globe temperature (WBGT) of 87. He was concerned about dehydration so drank as much water as possible at each hydration station. His partner reports he is confused since finishing. On exam, he is pale and diaphoretic with moist mucous membranes. He is awake, alert, and oriented to self and place but not to time or events. 



References

[1] Urso C, Brucculeri S, Caimi G. Physiopathological, Epidemiological, Clinical and Therapeutic Aspects of Exercise-Associated Hyponatremia. J Clin Med. 2014 Nov 12;3(4):1258-75. doi: 10.3390/jcm3041258. PMID: 26237602; PMCID: PMC4470181.

[2] Hew-Butler T, Rosner MH, Fowkes-Godek S, et al. Statement of the 3rd International Exercise-Associated Hyponatremia Consensus Development Conference, Carlsbad, California, 2015 British Journal of Sports Medicine 2015;49:1432-1446.

[3] Hew-Butler T, Loi V, Pani A, Rosner MH. Exercise-Associated Hyponatremia: 2017 Update. Front Med (Lausanne). 2017 Mar 3;4:21. doi: 10.3389/fmed.2017.00021. PMID: 28316971; PMCID: PMC5334560.