title: Fatal angioedema associated with enalapril.
abstract: A 65-year-old male with a long history of congestive heart failure presented to the emergency room with facial swelling 7 h after the first dose of enalapril. He was treated with diphenhydramine and hydrocortisone which improved his angioedema. However, there was a profound relapse of the angioedema followed by respiratory arrest. He suffered severe anoxic brain damage and died five days later. It is likely that the long half-life of enalapril lead to this rebound phenomenon. Enalapril induced angioedema is reviewed with suggestions for management.
authors.affiliation: Ottawa Heart Institute, Ottawa Civic Hospital, Ontario.
authors.forename: P J
authors.initials: PJ
authors.lastname: Giannoccaro
authors.forename: G J
authors.initials: GJ
authors.lastname: Wallace
authors.forename: L A
authors.initials: LA
authors.lastname: Higginson
authors.forename: W L
authors.initials: WL
authors.lastname: Williams
mesh_terms: D000368:Aged; D000799:Angioedema / Q000139:chemically induced*; D003327:Coronary Disease / Q000188:drug therapy*; D004656:Enalapril / Q000009:adverse effects* / Q000627:therapeutic use; D006333:Heart Failure / Q000188:drug therapy*; D006801:Humans; D002534:Hypoxia, Brain / Q000139:chemically induced; D008297:Male; D012131:Respiratory Insufficiency / Q000139:chemically induced
chemical_list: D004656:Enalapril