Angioedema Potentially Induced by Angiotensin Converting Enzyme Inhibitors

We report two cases of angioedema probably due to a side effect of angiotensin converting enzyme (ACE) inhibitors. In the first case, angioedema of the tongue was so severe that we had to perform a tracheotomy. In the second case, angioedema of the left arytenoid region and entire face was moderate and intubation was not required as the administration of high doses of corticosteroids and antihistamines effectively reduced the edema. Angioedema associated with ACE inhibitors has rarely been reported. Recent use of ACE inhibitors has increased however and the incidence of angioedema as a side effect of ACE inhibitor administration may be greater than generally estimated. Since angioedema can cause upper airway obstruction, we must be aware of this side effect and should be aware of the possible need to maintain an airway, and especially to be prepared for the possibility of surgical intervention. Detailed anamnesis regarding the use of ACE inhibitors will lead to a correct and prompt diagnosis.