Point-of-Care Sonographic Findings in Acute Upper Airway Edema

West J Emerg Med. 2016 Nov;17(6):822-826. doi: 10.5811/westjem.2016.9.31528. Epub 2016 Oct 4.

Abstract

We describe a case where a patient presented with acute angiotensin-converting enzyme inhibitor (ACE-I) induced angioedema without signs or symptoms of upper airway edema beyond lip swelling. Point-of-care ultrasound (POCUS) was used as an initial diagnostic test and identified left-sided subglottic upper airway edema that was immediately confirmed with indirect fiberoptic laryngoscopy. ACE-I induced angioedema and the historical use of ultrasound in evaluation of the upper airway is briefly discussed. To our knowledge, POCUS has not been used to identify acute upper airway edema in the emergency setting. Further investigation is needed to determine if POCUS is a sensitive and specific-enough tool for the identification and evaluation of acute upper airway edema.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Airway Obstruction
  • Angioedema / chemically induced
  • Angiotensin-Converting Enzyme Inhibitors / therapeutic use
  • Dyspnea / etiology
  • Edema / diagnosis*
  • Edema / diagnostic imaging
  • Female
  • Humans
  • Laryngoscopy
  • Point-of-Care Systems*
  • Ultrasonography*

Substances

  • Angiotensin-Converting Enzyme Inhibitors