Angioedema



Angioedema is something we’ll all encounter in the acute setting, whether we recognise it or not…

Understanding the different causes and mechanisms is imperative to ensuring the patients get treatment that is not only effective, but in extremis potentially lifesaving. In this episode we talk through the condition; from clinical presentation, causative agents, mechanisms of action, differentials and the evidence base of treatment.

Get in touch with any comments on the podcast, ensure to read the papers that are referenced yourself and draw your own conclusions.

Enjoy!

Simon & Rob

References & Further Reading

NICE guideline Angioedema and Anaphylaxis

Angioedema in the emergency department: a practical guide to differential diagnosis and management. Jonathan A Bernstein. Int J Emerg Med. 2017

Tranexamic acid as first-line emergency treatment for episodes of bradykinin-mediated angioedema induced by ACE inhibitors. Beauchêne C. Rev Med Interne. 2018 

Angioedema; EMCrit

Treatment of ACEi Induced Angioedema; PulmCrit

Are you sure that allergic allergic angioedema; St Emlyns

Icatibant for ACE inhibitor induced angioedema; St Emlyns

Angioedema; CORE EM

2 Comments

  • Hey guys. Thanks for the great podcast.
    The use of FFP is tricky in angioedema. As stated, there are a number of case reports touting its use in the ED. However, there’s a high likelihood of publication bias – it’s unlikely that I would publish a case report where I gave FFP and nothing happened or, where the patient worsened. There is potential for worsening as FFP contains bradykinin.
    Agree 100% that icatibant is no cure here and that giving TXA a shot is reasonable but the focus should be on whether the patient needs airway control or not. If they do, don’t delay to see if any meds work and if they don’t, watching and waiting as Rob stated is the best approach.
    Thanks again for the fantastic review!

    • Thanks Swami. Completely agree agree regarding the publication bias, but also a tricky subject to have a strong array of high quality studies to pin practice upon. Thanks also for your excellent podcast on the topic!

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