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Digoxin toxicity in heart-failure patients with Dr Paul Hauptman
Although not as frequently prescribed as it once was, digoxin is still a common fifth-line agent for heart-failure patients. Drs Ileana Piña and Paul Hauptman discuss a case of digoxin toxicity and how to recognize, treat, and avoid it.
See also:
Hussain Z, Swindle J, Hauptman PJ. Digoxin use and digoxin toxicity in the post-DIG trial era. J Card Fail 2006; 12:343-346. Abstract.
Conen D, Chae CU, Glynn RJ, et al. Risk of death and cardiovascular events in initially healthy women with new-onset atrial fibrillation. JAMA 2011; 305:2080-2087. Abstract.
Rathore SS, Wang Y, Krumholz HM. Sex-based differences in the effect of digoxin for the treatment of heart failure. N Engl J Med 2002; 347:1403-1411. Abstract.
Adams KF Jr, Patterson JH, Gattis WA, et al. Relationship of serum digoxin concentration to mortality and morbidity in women in the digitalis investigation group trial: a retrospective analysis. J Am Coll Cardiol 2005; 46:497-504. Abstract.
Withering W. An account of the foxglove and some of its medical uses with practical remarks on dropsy and other diseases. In: Willins FA, Keys TE, eds. Classics of Cardiology. New York: Henry Schyuman, Dover Publications, 1941:231-252.
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Comments
This was a helpful interview, but I have a question Regarding Digoxin Toxicity. How is the evidence of toxciity displayed? This was not covered during the interview.
Would the patient show an increase in fluid retention? Would the feet and/or legs show swelling? Would he or she expierence shortness of breath? Would BNP levels be higher? What other symptoms would be present to indicate toxicity?