Development of pulmonary edema related to heparin administration

Bleeding, thrombocytopenia, and osteopenia are recognized as the side effects of heparin administration. We recently noted occurrence of pulmonary edema in a patient with myelofibrosis with myeloid metaplasia being treated with heparin for pulmonary embolism. The hypertensive episodes preceding left ventricular failure were considered related to serotonin released from the immunologically mediated lowering of platelets.