Compartment syndrome of the thigh as a complication of anticoagulant therapy in a patient with a left ventricular assist device (Berlin Heart).

A nontraumatic case of compartment syndrome of the thigh in a patient on anticoagulant therapy for a left ventricular assist device (LVAD) is reported. A 51-year-old man was on low-molecular-weight heparin (LMWH) anticoagulation and antiplatelet drugs for his LVAD, when he had a spontaneous-onset compartment syndrome of the posterior compartment of the left thigh, which was treated with urgent fasciotomy. Although compartment syndromes in the thigh are rare and mostly traumatic in origin, all clinicians must maintain a high degree of suspicion; moreover, although most often bleeding associated with LMWH is minor, occasionally it results in a major bleed resulting in limb-threatening conditions such as a compartment syndrome.