Angiotensin-converting enzyme inhibitor-induced angioedema following carotid endarterectomy misdiagnosed as cervical hematoma

Ann Vasc Surg. 2006 Jan;20(1):145-7. doi: 10.1007/s10016-005-6859-8.


Angioedema is a localized swelling of sudden onset, often associated with angiotensin-converting enzyme (ACE) inhibitor use, that most commonly occurs in the face and neck. We present the case of a patient on long-term ACE inhibitor therapy for hypertension, who developed postoperative angioedema after carotid endarterectomy (CEA). The patient was initially misdiagnosed with an expanding cervical hematoma and underwent a surgical wound reexploration. Angioedema is a rare cause of neck swelling and upper airway distress occurring after CEA in patients treated with ACE inhibitors and should be considered in the differential diagnosis.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Angioedema / chemically induced*
  • Angioedema / diagnosis*
  • Angiotensin-Converting Enzyme Inhibitors / adverse effects*
  • Captopril / adverse effects
  • Carotid Artery, Internal*
  • Carotid Stenosis / surgery*
  • Diagnostic Errors*
  • Endarterectomy, Carotid*
  • Hematoma, Epidural, Spinal / diagnosis
  • Humans
  • Hypertension / complications
  • Hypertension / drug therapy
  • Male


  • Angiotensin-Converting Enzyme Inhibitors
  • Captopril