[Skin necroses and ergotism after preventive administration of heparin-dihydroergotamine]

About 30 hours after prophylactic subcutaneous administration of heparin-dihydroergotamine to a 77-year-old man with generalized arteriosclerosis, extensive skin necroses developed at the injection sites and, after progressively increasing signs of mental disorientation, three days later there developed acute pulmonary oedema and a large ischaemic infarct of the median cerebral artery with hemiparesis and coma, which ended fatally. Skin necroses and ergotism are rare but serious complications of anticoagulant treatment.