title: Supraglottic swelling may not correlate with tongue swelling in angiotensin converting enzyme inhibitor-induced angioedema.
abstract: Angioneurotic edema of upper airway tissues due to angiotensin converting enzyme inhibitor (ACEI) usage is a known perioperative complication of this class of medications. Swelling can begin rapidly, and typically involves the tongue and oral cavity. We have recently encountered four cases in which supraglottic edema developed after onset of tongue swelling and progressed despite resolving tongue edema. We present a representative case. This observation suggests that all patients with ACEI-induced angioedema should undergo laryngeal fiberoptic examination and appropriate airway management.
authors.affiliation: Department of Anesthesiology, University of Pittsburgh School of Medicine and VA Pittsburgh Health care system, Pittsburgh, Pennsylvania, USA. saxenas@anes.upmc.edu
authors.forename: Shashank
authors.initials: S
authors.lastname: Saxena
authors.forename: Brian
authors.initials: B
authors.lastname: Gierl
authors.forename: David E
authors.initials: DE
authors.lastname: Eibling
mesh_terms: D000368:Aged; D000799:Angioedema / Q000139:chemically induced* / Q000473:pathology*; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000009:adverse effects*; D005931:Glottis / Q000473:pathology; D006801:Humans; D007828:Laryngoscopy; D007830:Larynx / Q000473:pathology*; D008297:Male; D014059:Tongue / Q000473:pathology*
chemical_list: D000806:Angiotensin-Converting Enzyme Inhibitors