A Rash Decision. The Hazards of the Wrongful Use of Adrenaline

Anaphylaxis is life-threatening and should be addressed urgently. Its treatment is not without side effects and an accurate diagnosis must be made to prevent potential harm by the wrongful use of medication. A 46-year-old woman with hypertension treated with angiotensin converting enzyme inhibitor (...

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Detalhes bibliográficos
Autor principal: Coutinho Cruz, M (author)
Outros Autores: Sá Carvalho, R (author), Modas Daniel, P (author), Cruz Ferreira, R (author)
Formato: article
Idioma:eng
Publicado em: 2018
Assuntos:
Texto completo:http://hdl.handle.net/10400.17/2939
País:Portugal
Oai:oai:repositorio.chlc.min-saude.pt:10400.17/2939
Descrição
Resumo:Anaphylaxis is life-threatening and should be addressed urgently. Its treatment is not without side effects and an accurate diagnosis must be made to prevent potential harm by the wrongful use of medication. A 46-year-old woman with hypertension treated with angiotensin converting enzyme inhibitor (ACEI) presented to the emergency department with non-pitting oedema of the face and limbs. A hasty diagnosis of anaphylaxis was made and intravenous adrenaline administered. The patient developed a myocardial infarction caused by coronary artery spasm that required invasive intervention. The initial clinical picture was resolved when the ACEI was discontinued unmasking a case of ACEI-induced angioedema. The correct differentiation of these two apparently similar clinical entities is of utmost importance in the management of emergency department patients.