[Acute myocardial infarct after prophylactic administration of low doses of heparin-ergotamine: coronary artery spasm the cause?].

There have been several recent publications reporting vasospastic complications under heparin-dihydroergotamine prophylaxis. We report on 2 patients without significant coronary artery stenosis who died of acute myocardial infarction. Both patients had been operated on for a lumbar disc protrusion and were treated with 2500 IU heparin + 0.5 mg dihydroergotamine s.c. twice daily. The possibility of coronary arterial spasm as the cause of the myocardial infarctions is discussed. Publications reporting cases with myocardial infarctions, presumably caused by coronary arterial spasm, and other vasospastic complications under ergotamine therapy are briefly reviewed.