Multiple Fractures Associated With Long-term Sodium Heparin Therapy

Martin D. Jaffe, MD; Park W. Willis III, MD
JAMA. 1965;193(2):158-160. doi:10.1001/jama.1965.03090020072024.
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SODIUM HEPARIN, because of its anticoagulant and lipid-clearing effects, has gained widespread acceptance for the long-term treatment of coronary artery disease. Except for bleeding, usually the result of an excesssive therapeutic action, there have been few side effects reported. A previously unrecognized possible complication of heparin therapy is detailed here. A patient is presented in whom multiple fractures of vertebrae and ribs occurred in the last two months of a 13-month course of therapy with sodium heparin administered subcutaneously.

Report of a Case  A 41-year-old, married, white executive experienced angina pectoris in the summer of 1963 without clinically or electrocardiographically apparent myocardial infarction. Sodium heparin (Lipo-Hepin) therapy was started in October 1963. Each evening he received a single deep subcutaneous injection of 20,000 units (0.5 cc of 40,000 units/cc or approximately 200 mg) except for a 20-day period in August 1964, when he received approximately 280 mg nightly. The only


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