title: Vascular spasm and gangrene during heparin-dihydro-ergotamine prophylaxis.
abstract: A case is reported of a multiple trauma victim who developed severe vascular spasm whilst receiving heparin-dihydro-ergotamine thromboembolic prophylaxis which ultimately led to amputation of the right foot. Identification of high risk groups for this complication is attempted from a review of the literature. Treatment should be with intra-arterial or intravenous nitroprusside or nitrates. Little information is as yet available on the use of prostacyclin in this condition.
mesh_terms: D000328:Adult; D000792:Angiography; D004087:Dihydroergotamine / Q000009:adverse effects* / Q000627:therapeutic use; D004338:Drug Combinations / Q000009:adverse effects / Q000627:therapeutic use; D005260:Female; D005734:Gangrene; D006493:Heparin / Q000009:adverse effects* / Q000627:therapeutic use; D006495:Heparin, Low-Molecular-Weight; D006801:Humans; D007866:Leg / Q000098:blood supply*; D011183:Postoperative Complications / Q000517:prevention & control; D013035:Spasm / Q000139:chemically induced; D013923:Thromboembolism / Q000517:prevention & control*; D014652:Vascular Diseases / Q000139:chemically induced* / Q000000981:diagnostic imaging
chemical_list: D004338:Drug Combinations; D006495:Heparin, Low-Molecular-Weight; C031388:heparin-dihydergot; D004087:Dihydroergotamine; D006493:Heparin