A 45-year-old man with hypertension on ramipril reports swollen lips, a dry cough, and shortness of breath. What is the most appropriate advice?

A 45-year-old man with hypertension on ramipril reports swollen lips, a dry cough, and shortness of breath. What is the most appropriate advice?

• A. Refer the patient to A&E
• B. Advise to continue medication and monitor
• C. Stop the medication and re-evaluate later
• D. Take an antihistamine and reassess

Answer: (A)

ACE inhibitors can cause angioedema due to bradykinin buildup. Angioedema can involve the lips, tongue, and airway and may progress rapidly, leading to airway obstruction with shortness of breath. This scenario signals a potentially life-threatening reaction, so urgent emergency assessment is needed to secure the airway and stop the offending drug. The cough is a known ACE inhibitor side effect but does not explain the acute airway symptoms, and waiting or simply relying on an antihistamine could delay critical care. The safest action is urgent referral to A&E for immediate evaluation, airway management if needed, and discontinuation of ramipril.

ACE inhibitors can cause angioedema due to bradykinin buildup. Angioedema can involve the lips, tongue, and airway and may progress rapidly, leading to airway obstruction with shortness of breath. This scenario signals a potentially life-threatening reaction, so urgent emergency assessment is needed to secure the airway and stop the offending drug. The cough is a known ACE inhibitor side effect but does not explain the acute airway symptoms, and waiting or simply relying on an antihistamine could delay critical care. The safest action is urgent referral to A&E for immediate evaluation, airway management if needed, and discontinuation of ramipril.