Vascular spasm and gangrene during heparin–dihydro-ergotamine prophylaxis

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Abstract
A case is reported of a multiple trauma victim who developed severe vascular spasm whilst receiving heparin-dihydro-ergotamine thrombo-embolic 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.