Fatal angioedema associated with enalapril.
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.
Giannoccaro
P J
PJ
Ottawa Heart Institute, Ottawa Civic Hospital, Ontario.
Wallace
G J
GJ
Higginson
L A
LA
Williams
W L
WL
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
D004656:Enalapril