Brief description of condition
Angioedema is a sudden swelling and affects areas of skin and mucous membranes, typically the lips or tongue. It can be caused by an allergic-like response. For the majority of sufferers the condition is a nuisance, but for some it can be life- threatening, if the swelling affects the mouth, throat or tongue with possible airway obstruction.
There are four main types of angioedema (allergic, idiopathic, drug-induced and hereditary).
Key signs and symptoms
- Sudden onset (within minutes) obvious swelling, with or without itch.
- Swelling usually round the eyes and lips but can affect the throat, hands and feet.
- If there are breathing difficulties (wheezing), itching (urticaria). and the patient is hypotensive (flushed or faint) it could be a severe allergic reaction or anaphylaxis.
Determine if the airway is compromised: speech, swallowing or breathing are restricted, the patient is unable to swallow their own saliva or they are unable to push their tongue forward out of their mouth.
If the airway is compromised
Send the patient immediately to emergency care via NHS 24 or call 999.
If the airway not compromised:
- If the swelling is severe, advise the patient to seek urgent medical care which might include oral or intravenous steroids and antihistamine.
- Note that if patient has an EpiPen, it would be appropriate for them to use it.
- If the swelling is mild and static or diminishing, this is generally self-limiting and resolves spontaneously and therefore no action is required. Advise the patient to seek non-urgent medical care to review medication and discuss prophylaxis.
Provide follow up medical care to identify the cause of angioedema and to establish if there is any relevant underlying medical condition (e.g. urticaria) that requires ongoing medical care.