Which factor increases the risk of orolingual angioedema after thrombolysis?

Which factor increases the risk of orolingual angioedema after thrombolysis?

• A. ACE inhibitors
• B. Regular exercise
• C. Vitamin C supplementation
• D. NSAID use

Answer: (A)

ACE inhibitors raise the risk of orolingual angioedema because they block the breakdown of bradykinin, a molecule that increases vascular permeability and causes swelling. Thrombolysis can also activate the kallikrein-kinin system, releasing more bradykinin. When both factors are present, bradykinin levels rise further, making swelling in the tongue and lips more likely. The other options don’t specifically predispose to this bradykinin-mediated angioedema in the thrombolysis setting. This condition is a potential airway emergency, so rapid assessment and management of the airway are essential.

ACE inhibitors raise the risk of orolingual angioedema because they block the breakdown of bradykinin, a molecule that increases vascular permeability and causes swelling. Thrombolysis can also activate the kallikrein-kinin system, releasing more bradykinin. When both factors are present, bradykinin levels rise further, making swelling in the tongue and lips more likely. The other options don’t specifically predispose to this bradykinin-mediated angioedema in the thrombolysis setting. This condition is a potential airway emergency, so rapid assessment and management of the airway are essential.