Abstract
Angiotensin-converting enzyme inhibitors (ACEIs) are widely used for treatment of hypertension, congestive heart failure, and cardiovascular and renal protection in patients with heart failure, among others. Angioedema is a rare but potentially fatal adverse event (ACEI-AAE), whose prevalence is under 0.5 % among patients taking ACEIs and is higher among African Americans and female patients. There is no biomarker that allows diagnosis of ACEI-AAE, and the diagnosis is based on clinical history and the intake of ACEIs. Differential diagnosis with other causes of edema/angioedema must be considered. Recent classifications of angioedema can be of great help in the diagnosis process. The management of ACEI-induced angioedema involves the withdrawal of the causative drug and the treatment of the acute angioedema with different off-label drugs (icatibant, plasma-derived human C1 inhibitor protein). This manuscript will review the epidemiology, pathophysiology, genetics, clinical symptoms, diagnosis, and treatment of ACEI-AAE.
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