Recently, a patient presented with angioedema after starting taking an ACE-inhibitor. There was upper lip swelling, similar appearing to the case above. He also experience a hoarse voice. Before the advent of fiberoptic nasopharyngoscopy, it was assumed that there may be laryngeal edema. Fortunately, using technology, we were able to visualize a normal epiglottis and a grossly normal laryngeal anatomy.
An example of an abnormal nasopharyngoscopy image is shown below with a slightly edematous epiglottis, normal vocal cords, and normal arytenoid cartilage.
This installment of the Paucis Verbis (In a Few Words) e-card series reviews Angioedema.
The 1999 study on admission guidelines, of course, should be weighed with physician judgment and the patient's social issues. The study was retrospective and the results should be weighed carefully. For me, generally I admit all intraoral angioedema cases and progressively worsening extraoral angioedema. I also perform fiberoptic nasopharyngoscopy on all patients with voice changes.
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