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Pathology
Digoxin is widely prescribed however toxicity is rare in comparison, the main
route of elimination is via the kidneys
Aetiology
Occurs in overdose of digoxin but more commonly occurs in elderly patients
with deteriorating renal function.Signs
Bradycardia Hypotension, cardiogenic shock
Symptoms
Lethargy, Xanthopsia (yellow vision), nausea, vomiting and dizziness
.Investigations
loods: Digoxin level, magnesium, U+E’s
ECG: ‘reverse tick’ sign, bradycardia, AV block, AF, paroxysmal atrial tachycardia
VT, VF
Treatment
Stop digoxin
Cardiac monitoring
Digibind
A temporary pacing wire may be required
Prognosis
Depends on comorbidities and age
Bradycardias, AV block, atrial tachycardia with 2:1 block, bidirectional VT.
Digoxin can also initiate AF in patients with a normal sinus rhythm
Key Facts
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Key References
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