• Emerg. Med. Clin. North Am. · Feb 2022

    Review

    Angiotensin-Converting Enzyme Inhibitor-Induced Angioedema.

    • R Gentry Wilkerson and Michael E Winters.
    • Department of Emergency Medicine, University of Maryland School of Medicine, 110 South Paca Street, 6th Floor, Suite 200, Baltimore, MD 21201, USA. Electronic address: gwilkerson@som.umaryland.edu.
    • Emerg. Med. Clin. North Am. 2022 Feb 1; 40 (1): 79-98.

    AbstractAngioedema is a well-recognized and potentially lethal complication of angiotensin-converting enzyme inhibitor (ACEi) therapy. In ACEi-induced angioedema, bradykinin accumulates due to a decrease in its metabolism by ACE, the enzyme that is primarily responsible for this function. The action of bradykinin at bradykinin type 2 receptors leads to increased vascular permeability and the accumulation of fluid in the subcutaneous and submucosal space. Patients with ACEi-induced angioedema are at risk for airway compromise because of the tendency for the face, lips, tongue, and airway structures to be affected. The emergency physician should focus on airway evaluation and management when treating patients with ACEi-induced angioedema.Copyright © 2021 Elsevier Inc. All rights reserved.

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