Cargando…

Angiotensin-Converting Enzyme Inhibitor-Induced Angioedema With Resultant Airway Obstruction Following Endotracheal Intubation

Angiotensin-converting enzyme inhibitor (ACEi)-induced angioedema is a consequence of excessive levels of bradykinin and accounts for nearly a third of angioedema cases when patients present to emergency rooms. While rare, patients can present with swelling in the face, tongue, and airways making it...

Descripción completa

Detalles Bibliográficos
Autores principales: Vazirnia, Parsia, Choroomi, Yasmine, Marfowaa, Gifty, Razzak, Abrahim N, Quinn, Brian
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Cureus 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10183302/
https://www.ncbi.nlm.nih.gov/pubmed/37197111
http://dx.doi.org/10.7759/cureus.37594
_version_ 1785041926715604992
author Vazirnia, Parsia
Choroomi, Yasmine
Marfowaa, Gifty
Razzak, Abrahim N
Quinn, Brian
author_facet Vazirnia, Parsia
Choroomi, Yasmine
Marfowaa, Gifty
Razzak, Abrahim N
Quinn, Brian
author_sort Vazirnia, Parsia
collection PubMed
description Angiotensin-converting enzyme inhibitor (ACEi)-induced angioedema is a consequence of excessive levels of bradykinin and accounts for nearly a third of angioedema cases when patients present to emergency rooms. While rare, patients can present with swelling in the face, tongue, and airways making it a life-threatening emergency. To secure an airway, endotracheal intubation may be conducted; however, tracheal stenosis is a known complication. In this report, we present a 61-year-old female with a history of ACEi-induced angioedema care in which she was intubated with facial swelling. Upon a repeat hospitalization, the patient developed stridor with respiratory distress. Bronchoscopy revealed severe tracheal stenosis with multilevel damage to tracheal rings, warranting urgent tracheostomy. One month after discharge, the patient was seen by an ENT specialist who performed a transnasal laryngoscopy revealing near total subglottic and tracheal stenosis of 3 cm stenosis length, presumed secondary to traumatic intubation for prior angioedema management. This case highlights the importance of careful intubation practices in patients with suspected airway edema. 
format Online
Article
Text
id pubmed-10183302
institution National Center for Biotechnology Information
language English
publishDate 2023
publisher Cureus
record_format MEDLINE/PubMed
spelling pubmed-101833022023-05-16 Angiotensin-Converting Enzyme Inhibitor-Induced Angioedema With Resultant Airway Obstruction Following Endotracheal Intubation Vazirnia, Parsia Choroomi, Yasmine Marfowaa, Gifty Razzak, Abrahim N Quinn, Brian Cureus Internal Medicine Angiotensin-converting enzyme inhibitor (ACEi)-induced angioedema is a consequence of excessive levels of bradykinin and accounts for nearly a third of angioedema cases when patients present to emergency rooms. While rare, patients can present with swelling in the face, tongue, and airways making it a life-threatening emergency. To secure an airway, endotracheal intubation may be conducted; however, tracheal stenosis is a known complication. In this report, we present a 61-year-old female with a history of ACEi-induced angioedema care in which she was intubated with facial swelling. Upon a repeat hospitalization, the patient developed stridor with respiratory distress. Bronchoscopy revealed severe tracheal stenosis with multilevel damage to tracheal rings, warranting urgent tracheostomy. One month after discharge, the patient was seen by an ENT specialist who performed a transnasal laryngoscopy revealing near total subglottic and tracheal stenosis of 3 cm stenosis length, presumed secondary to traumatic intubation for prior angioedema management. This case highlights the importance of careful intubation practices in patients with suspected airway edema.  Cureus 2023-04-14 /pmc/articles/PMC10183302/ /pubmed/37197111 http://dx.doi.org/10.7759/cureus.37594 Text en Copyright © 2023, Vazirnia et al. https://creativecommons.org/licenses/by/3.0/This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Internal Medicine
Vazirnia, Parsia
Choroomi, Yasmine
Marfowaa, Gifty
Razzak, Abrahim N
Quinn, Brian
Angiotensin-Converting Enzyme Inhibitor-Induced Angioedema With Resultant Airway Obstruction Following Endotracheal Intubation
title Angiotensin-Converting Enzyme Inhibitor-Induced Angioedema With Resultant Airway Obstruction Following Endotracheal Intubation
title_full Angiotensin-Converting Enzyme Inhibitor-Induced Angioedema With Resultant Airway Obstruction Following Endotracheal Intubation
title_fullStr Angiotensin-Converting Enzyme Inhibitor-Induced Angioedema With Resultant Airway Obstruction Following Endotracheal Intubation
title_full_unstemmed Angiotensin-Converting Enzyme Inhibitor-Induced Angioedema With Resultant Airway Obstruction Following Endotracheal Intubation
title_short Angiotensin-Converting Enzyme Inhibitor-Induced Angioedema With Resultant Airway Obstruction Following Endotracheal Intubation
title_sort angiotensin-converting enzyme inhibitor-induced angioedema with resultant airway obstruction following endotracheal intubation
topic Internal Medicine
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10183302/
https://www.ncbi.nlm.nih.gov/pubmed/37197111
http://dx.doi.org/10.7759/cureus.37594
work_keys_str_mv AT vazirniaparsia angiotensinconvertingenzymeinhibitorinducedangioedemawithresultantairwayobstructionfollowingendotrachealintubation
AT choroomiyasmine angiotensinconvertingenzymeinhibitorinducedangioedemawithresultantairwayobstructionfollowingendotrachealintubation
AT marfowaagifty angiotensinconvertingenzymeinhibitorinducedangioedemawithresultantairwayobstructionfollowingendotrachealintubation
AT razzakabrahimn angiotensinconvertingenzymeinhibitorinducedangioedemawithresultantairwayobstructionfollowingendotrachealintubation
AT quinnbrian angiotensinconvertingenzymeinhibitorinducedangioedemawithresultantairwayobstructionfollowingendotrachealintubation