[Hypovolemic shock due to spontaneous hemorrhage associated with heparin anticoagulant treatment; a report of 5 cases]. / Shock hipovolémico por hemorragia espontánea asociada a tratamiento anticoagulante con heparina; presentación de cinco casos.

Hypovolemic shock occasioned for the spontaneous hemorrhage is a complication very rare in the course of the anticoagulant therapy with heparin. We are going to introduce you five cases where a therapy with heparin produced spontaneous hemorrhage and hypovolemic shock. We noticed them in our Intensive Medicine Service in five the last ones years. In all the patients we found helping factors of hemorrhage. In two of the patients the hemorrhage took place in spite of to maintain an activated partial-thromboplastin time (APTT) inside the therapeutic range of anticoagulation; another two presented a APTT excessively elongated; and a patient had it completely normal. In all the cases the hemoglobin and hematocrit values were normals at the beginning; however the pain ws always in all the patients and gave us an idea about the place where the bleeding was. In a patient the computed tomographic (CT) confirmed the diagnosis. In two cases the treatment was surgical. We explain coadyuvanted factors that are required in the hemorrhage genesis in anticoagulated patients with heparin.