Case of a Soleus Muscle Hematoma with Compartment Syndrome Complicated by Enoxaparin and Aspirin Therapy

ABSTRACT

Enoxaparin is a low-molecular-weight heparin that has been widely used in acute coronary syndrome patients. The tolerability profile of enoxaparin is at least similar to that of unfractionated heparin, but the incidences of local hematomas and increased liver enzymes are lower. We experienced one case of enoxaparin-associated soleus muscle hematoma with compartment syndrome. An 83 year-old woman received enoxaparin (1 mg/kg q 12 hours) and oral aspirin (100 mg qd) therapy due to a non-ST elevation myocardial infarction. On the 3rd hospital day, she complained of pain and a tingling sensation in her left calf muscle. A left lower leg CT scan showed a 5.1 x 2.3 x 1.5 cm hematoma compressing the left soleus muscle. An Emergency operation was done to extract the large hematoma. Whenever acute symptoms, including leg pain, tingling sensation, and anemia occur during anticoagulation therapy, the possibility of enoxaparin-associated hematoma should be considered.