Home About us Editorial board Search Ahead of print Current issue Archives Submit article Instructions Subscribe Contacts Login 
Year : 2021  |  Volume : 31  |  Issue : 3  |  Page : 184-186

Angiotensin-converting enzyme inhibitor-induced oropharyngeal edema with subsequent stress-cardiomyopathy

1 Department of Medicine, St. Lukes Hospital, Kilkenny, Ireland
2 University of Limerick School of Medicine, Castletroy, Limerick, Ireland

Correspondence Address:
Michael Cronin
Department of Medical, St. Lukes Hospital, Freshford Road, Kilkenny
Login to access the Email id

Source of Support: None, Conflict of Interest: None

DOI: 10.4103/jcecho.jcecho_40_21

Rights and Permissions

Intramuscular adrenaline is a standard treatment approach for the symptomatic patient presenting with distress and oropharyngeal edema, requiring subsequent doses if oedema persists. This case demonstrates a delayed side-effect of stress-induced cardiomyopathy after adrenaline administration. A 62-year-old suffered acute oropharyngeal angioedema secondary to angiotensin-converting-enzyme inhibitor use. Two standard doses of intramuscular adrenaline 2 hours apart were administered, and she was monitored for 2 days. On day three post discharge, she represented with acute hypervolaemia. Transthoracic echocardiogram showed a globally dilated, poorly functioning left ventricle. Cardiac magnetic resonance imaging described takotsubo cardiomyopathy. One month later, left ventricular function had normalised with optimal medical treatment. Cardiomyopathy with a temporal relationship to a hypersensitivity reaction is thought to occur due to one of three mechanisms: Stress (takotsubo) cardiomyopathy, allergic acute coronary (Kounis) Syndrome, and hypersensitive myocarditis. If a clinical presentation of hypersensitivity is such that it requires treatment with epinephrine, it is particularly challenging to determine the exact cause of cardiomyopathy.

Print this article     Email this article
 Next article
 Previous article
 Table of Contents

 Similar in PUBMED
   Search Pubmed for
   Search in Google Scholar for
 Related articles
 Citation Manager
 Access Statistics
 Reader Comments
 Email Alert *
 Add to My List *
 * Requires registration (Free)

 Article Access Statistics
    PDF Downloaded12    
    Comments [Add]    

Recommend this journal