Symptoms of Angioedema

Angioedema generally occurs suddenly and produces swelling of the face, arms, or legs. Symptoms can range in severity, and they are rarely life-threatening. There are a few types of angioedema that largely produce the same symptoms, among them swelling, redness, and GI discomfort.

Common Symptoms

The most common symptoms of angioedema occur after exposure to something that triggers an allergic reaction, such as food, medication, clothing, cosmetics, or an insect bite. Sometimes the symptoms begin without an identifiable reason. And, if you have hereditary angioedema, they can occur in response to an allergen, to stress, or, more often, without a reason.

Angioedema progresses rapidly within a few hours. Often, it can resolve on its own within one to three days. Symptoms resolve gradually.

The most common symptoms of angioedema include:

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• Swelling: The hallmark of angioedema is swelling and puffiness of the eyes or lips. It may also affect the hands, feet or legs, and less often may involve genitalia. Swelling can develop in the throat and tongue as well, and this can affect breathing or eating due to physical obstruction of the airway and food pipe. Swelling is not pitting, meaning that you cannot produce an indentation in the puffy area by pressing on it.
• Redness: Redness can accompany the swelling or may appear on its own. It can appear as numerous small spots or as patchy areas and can be raised or flat. It may appear anywhere on the body, including areas that are not swollen, but often affects swollen areas or appears at the edges of the swollen areas. Redness is often blanching, which means that it briefly becomes pale when you press on it, but then returns to red again within a few minutes.
• Rash: A rash, which may appear as small bumps or flat areas clustered together, can develop anywhere on the skin and is usually reddish.
• Patchy welts: You can develop patches of slightly raised skin, usually reddish or pink in color. These patches are often described as welts. 
• Dizziness: A sense of mild to moderate lightheadedness can accompany the skin changes of angioedema.
• Stomach upset: You may experience stomach discomfort or nausea in association with angioedema, and this, like the other symptoms, should resolve when the visible symptoms on the skin resolve.

Less Common Symptoms

In general, the changes associated with angioedema affect the appearance of the skin without causing discomfort. You can experience sensory changes of the skin, diarrhea, or trouble breathing, although these symptoms are less common.

• Itching: Occasional itching may accompany the redness and swelling with angioedema, but usually, itching is a sign of other conditions such as contact dermatitis.
• Tingling: Tingling or another non-painful sensation can accompany the swelling of angioedema.
• Burning: A mildly painful burning sensation may occur with angioedema, particularly on the swollen areas of the body.
• Diarrhea: Occurring less often than most symptoms, mild diarrhea can accompany angioedema. This occurs as a result of swelling of the digestive system. It is especially rare for diarrhea to be the only symptom of angioedema, although this can happen.
• Trouble eating: If your tongue and throat become swollen due to angioedema, the swelling may physically interfere with your ability to chew and swallow food. This can increase your chances of choking.
• Breathing difficulties: Swelling does not usually involve the throat and tongue, but when it does, breathing difficulties may occur as a result of physical obstruction of your airway.

Complications

Generally, angioedema resolves on its own or with treatment. However, while it is not common, angioedema can cause serious, or even life threatening, complications.

Complications of angioedema include:

• Breathing obstruction: If the swelling in your throat and tongue is extensive, this can impair breathing, preventing air from getting through efficiently. In rare instances, this is a medical emergency, requiring medical or surgical intervention to clear your airway.
• Shortness of breath: Shortness of breath may occur with angioedema. This is different than the breathing difficulty that occurs due to tongue and throat swelling. In some instances, angioedema can induce actual changes in your respiratory abilities, which requires urgent medical attention.
• Respiratory arrest: If you have angioedema, your immune system can overreact to such an extent that breathing suddenly stops. This is a life-threatening situation requiring emergency medical assistance.

When to See a Doctor

It is not possible to predict whether your symptoms will become worse, especially if you have not had angioedema before. And, because the symptoms of angioedema are so sudden and often vague, it is hard to know what is happening. If you experience any of the following symptoms, you should seek medical attention:

• Shortness of breath: If you experience shortness of breath or feel that you cannot breathe, this could get worse very quickly. You should call for emergency help. If your child or someone else becomes short of breath, you should call for emergency help as well.
• Faintness, dizziness, or lightheadedness: This could be a sign that you are having a severe reaction that may not quickly resolve on its own.
• Swelling of your throat or tongue: As with shortness of breath, things can progress rapidly. Even if you are fully conscious, the swelling may quickly block your airway.
• A strong allergic reaction: If you have had a serious, life-threatening reaction to an allergen before, you could have the same response upon repeated exposure to the allergen. This includes shortness of breath, loss of consciousness, tongue swelling, or heart symptoms. If you have a tendency to have a severe reaction to a particular allergen, eventually you will be able to administer your own treatment, possibly with an EpiPen, whenever symptoms start to occur.

Frequently Asked Questions

What is angioedema?

Angioedema is the abrupt swelling of the skin, mucous membranes, or both. It differs from hives (urticaria) in that the swelling occurs in deep tissues. Angioedema mainly affects the lips, face, and extremities, but can also occur on the genitals, larynx (windpipe), and gut. It frequently occurs with urticaria.

What causes allergic angioedema?

Allergic angioedema occurs when the immune system reacts abnormally to an allergen and releases histamine into the bloodstream. Histamine causes the rapid dilation of blood vessels as well as the leakage of fluid into surrounding tissues, leading to angioedema.

What causes hereditary angioedema?

Hereditary angioedema is caused by a genetic deficiency of an anti-inflammatory substance known as a C1 inhibitor. The lack of C1 inhibitor enables the unchecked production of a compound called bradykinin that triggers the dilation of blood vessels. The unprovoked dilation along with the leakage of fluid lead to angioedema.

What are common angioedema triggers?

Angioedema can be triggered by a wide range of substances, events, and conditions including:

• Food allergy
• Drug hypersensitivity
• Pollen and other airborne allergens
• Stress
• Insect bites
• Exposure to sunlight
• Extreme changes in temperature
• Extreme vibrations
• Vigorous exercise
• Wearing tight clothing

What does angioedema look like?

Angioedema is characterized by the following signs and symptoms:

• Deep, non-pitting welts that form within minutes to hours
• Swelling and redness, most frequently around the eyes, cheeks, or lips but also on the limbs, tongue, and genitals
• Warmth and sometimes pain

What are uncommon signs of angioedema?

When angioedema affects the gastrointestinal tract, it can cause abdominal pain, nausea, and vomiting. When it affects the larynx, it can become life-threatening, causing airway restriction and possible suffocation. Angioedema may also be a feature of a life-threatening, whole-body allergy known as anaphylaxis.

How is angioedema treated?

Mild cases of angioedema may not need treatment. If treatment is needed, over-the-counter or prescription antihistamines may be prescribed. Severe and/or chronic cases may require prescription corticosteroids like prednisone or immunosuppressants like cyclosporine to temper the immune response and bring down inflammation.

For anaphylaxis, the rapid administration of injected epinephrine is needed to prevent anaphylactic shock and other potentially life-threatening symptoms.