Madalena Coutinho Cruz, Ramiro Sá Carvalho, Pedro Modas Daniel, Rui Cruz Ferreira
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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 (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.
期刊介绍：
The Romanian Journal of Anaesthesia and Intensive Care is the official journal of the Romanian Society of Anaesthesia and Intensive Care and has been published continuously since 1994. It is intended mainly for anaesthesia and intensive care providers, but it is also aimed at specialists in emergency medical care and in pain research and management. The Journal is indexed in Scopus, Embase, PubMed Central as well as the databases of the Romanian Ministry of Education and Research (CNCSIS) B+ category. The Journal publishes two issues per year, the first one in April and the second one in October, and contains original articles, reviews, case reports, letters to the editor, book reviews and commentaries. The Journal is distributed free of charge to the members of the Romanian Society of Anaesthesia and Intensive Care.
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