lisinopril and Vomiting

Topics: Angioedema; Angiotensin-Converting Enzyme Inhibitors; Antihypertensive Agents; Austria; Diarrhea; Dyspepsia; Humans; Incidence; Lisinopril; Nausea; Pyridines; Randomized Controlled Trials as Topic; Retrospective Studies; Thiazepines; Urticaria; Vomiting

Pheochromocytoma is a rare catecholamine-secreting tumour that is typically located in the adrenal medulla or along the sympathetic ganglia. The typical symptoms are episodic in nature and include tachycardia, sweating and headache. These tumours can present as transient, reversible cardiomyopathy similar to takotsubo cardiomyopathy (TCM). TCM is characterised by transient hypokinesis of the left ventricular apex and is typically induced by emotional stress. We describe the case of a 26-year-old woman with a medical history significant for headaches who presented initially to her family physician with nausea, vomiting, headache and hypertension. She was started on lisinopril 10 mg daily. One week later, she presented to the emergency department with substernal severe chest pressure. Her troponin level was elevated. Coronary angiogram showed normal coronary arteries and left ventriculogram showed inverse TCM pattern. Serum catecholamines were very elevated confirming pheochromocytoma. She was successfully treated with alpha-blockers followed by surgical resection.

Topics: Adrenal Gland Neoplasms; Adrenergic alpha-Antagonists; Adult; Antihypertensive Agents; Coronary Angiography; Electrocardiography; Female; Headache; Humans; Hypertension; Lisinopril; Nausea; Pheochromocytoma; Takotsubo Cardiomyopathy; Treatment Outcome; Vomiting

To report a case of possible lisinopril-induced angioedema of the small bowel.. A 67-year-old female was admitted to the hospital with abdominal pain, nausea, vomiting, and diarrhea. A computed tomography (CT) scan of the abdomen/pelvis was obtained which showed wall thickening around the area of the jejunum and scant ascites consistent with several diagnoses, including small bowel angioedema. She was treated with intravenous fluids and nasogastric decompression. Stool studies were negative. Her lisinopril was held due to the possibility of small bowel angioedema. A CT enterography obtained 5 days after the discontinuation of lisinopril showed complete resolution of the inflammatory changes and perihepatic fluid. It was felt that angiotensin-converting enzyme inhibitor (ACEI)-induced angioedema of the small bowel was the most likely etiology of her symptoms.. Angiotensin-converting enzyme inhibitor small bowel angioedema is an uncommon cause of abdominal symptoms. In several cases, patients had been taking ACEIs for years before symptoms occur. Treatment includes cessation of the ACEI and supportive care.. Angiotensin-converting enzyme inhibitor-related small bowel angioedema should be considered in the differential diagnosis of unexplained abdominal pain.

Topics: Abdominal Pain; Aged; Angioedema; Angiotensin-Converting Enzyme Inhibitors; Diagnosis, Differential; Diarrhea; Female; Humans; Intestinal Diseases; Intestine, Small; Lisinopril; Nausea; Time Factors; Tomography, X-Ray Computed; Vomiting

Topics: Abdominal Pain; Adult; Angioedema; Angiotensin-Converting Enzyme Inhibitors; Biopsy; Female; Humans; Hypertension; Ileal Diseases; Ileum; Lisinopril; Magnetic Resonance Imaging; Nausea; Recurrence; Vomiting