The angioedema


Angioedema (swelling of the vessel) or also known as Quincke’s edema, is a sudden swelling of the skin and subcutaneous tissue, sometimes lasting several days. Swelling of the lip, tongue and eye is relatively harmless. On the other hand, swelling of the glottis (the part of the larynx that forms the voice) can be life-threatening.

Associated symptoms

Classic angioedema is typically accompanied by generalized itching and tightness of the skin. Depending on which other parts of the body are affected, swelling of the connective tissue can cause unspecific symptoms. For example, hereditary angioedema can cause pain or digestive disorders, as edema can form in the gastrointestinal tract.

This is, however, a rare symptom. More obvious would be complaints from the allergic form. In this case the vessels in our body relax and dilate.

The dilation of the vessels can lead to a sudden drop in central venous pressure. The blood pressure drops so sharply that one can pass out (so-called hypotensive syncope). This may be preceded by symptoms such as malaise, dizziness, sweating, palpitations and “soft knees”. Like any allergic reaction, this can be excessive and result in an allergic shock. Untreated angioedema, perhaps combined with oedema from other diseases, for example right heart failure, can cause watery tension blisters of the skin or other skin changes.

Localizations of the angioedema

The lips are a preferred site for the development of oedema because they have a thin layer of skin and delicate connective tissue with few tight collagen fibres. As a rule, the lips do not swell as much, so that oral passage is not misplaced. However, massive swelling can become unpleasant and appear unaesthetic.

As the skin and mucous membrane of the lips are a rapidly regenerating cell layer, no permanent damage is to be expected. This topic might also be of interest to you: Swollen lips. Angioedema of the face is not more dangerous than other forms of oedema, apart from the aesthetic aspects.

The skin of the face is a predictive site for the development of edema, as the skin and subcutaneous tissue are more tender. For example, there is less tight connective tissue there than in the legs or feet. In addition, the facial skin is exposed to less mechanical stress than the skin on the hands.

In addition, the facial skin and the subcutaneous tissue are particularly well supplied with blood. The number of blood vessels is important in the development of oedema and promotes this. The eyelid is also a predictive site for oedema due to its anatomy.

Cushioned by little subcutaneous fatty tissue and provided with delicate connective tissue, it swells more than other parts of the face. Usually it swells so much that free vision through one eye or even both eyes is prevented. This circumstance naturally carries its own dangers or limitations (e.g. unfitness to drive) and should be remedied as soon as possible.

If one eye swells so much that it compresses the vitreous body (lat. bulbus) of the eye or increases the pressure in the eye, this can lead to an acute glaucoma attack or cause pain. – Edema of the eye

The most feared complication of angioedema is glottis oedema, i.e. swelling of the glottis. This is located in the middle level of the larynx and represents the opening between the mouth/throat and the lungs. Glottal edema is manifested by sudden respiratory distress and difficulty in speaking, such as dumpy or hoarse speech.

Swelling of the tongue can be problematic because speech is impaired and saliva drainage can be displaced along the throat. It can also cause breathing difficulties. The swelling of the tongue, especially in the back of the tongue, can cut off the path of the air. Medications can also no longer be taken in through the mouth, but must be administered through the vein.