Life Threatening Airway Angioedema Secondary to Captopril

Feriyde Çalışkan Tür*, Murat Yeşilaras , Şule Cömert and Serkan Hacar

Life Threatening Airway Angioedema Secondary to Captopril

A 38 year old female patient was brought to emergency department by the first aid
team following an epileptic seizure. She was in a postictal state at arrival.

The patient was oriented and cooperative but fell asleep easily.
Her Glasgow coma score was 14.

Here vital signs were as follows: Blood pressure 190/124 mmHg,
pulse 88/min, breathing rate 22/min, temperature 36.5 °C,
and oxygen saturation in room air was 99% by pulse oximetry.

Her physical impression was normal.

She had no active complaints. Her medical history included meningitis
in childhood, hypertension, and epilepsy.

Her elevated blood pressure was treated prehospital with
50 mg of captopril. A finger sticks blood sugar test was 134 mg/dL.

Twenty minutes after arrival in the emergency department,
tachypnea, perioral oedema, and rhonchi developed.

Angioedema due to ACEI generally develops in face and neck area without urticaria.
Sometimes there may be severe abdominal pain due to visceral
oedema of the intestines, mimicking symptoms of appendicitis
or Familial Mediterranean Fever.

Accumulation of bradykinin, increased number of mast cells
and increasing histamine release play a role in the pathophysiology.
Female gender, African race, and genetic polymorphism are enhancing risk factors.

ACEI’s are the cause of 10-25% of all angioedema cases.
Defective or reduced substance P and des-Ard9-BK enzymes that
metabolize bradykinin, result in an increase of this substance in
circulation.

Emerg Med Open J. 2015; 1(1): 12- 14. doi: 10.17140/EMOJ-1-103

LATEST ARTICLES

 - 
Arabic
 - 
ar
Bengali
 - 
bn
German
 - 
de
English
 - 
en
French
 - 
fr
Hindi
 - 
hi
Indonesian
 - 
id
Portuguese
 - 
pt
Russian
 - 
ru
Spanish
 - 
es