digitoxin and Atrioventricular-Block

Topics: Atrioventricular Block; Digitalis; Digoxin; Dose-Response Relationship, Drug; Electrocardiography; Humans; Plant Leaves; Plant Poisoning; Suicide, Attempted

A previously well woman aged 63 years presents to the emergency department with vomiting, palpitations and 3 presyncopal episodes. She had no previous medical or cardiac history, with the patient stating that she tried a herbal remedy of boiled comfrey leaves for insomnia 18 hours before arrival to the department. Her ECG showed multiple abnormalities, including bradycardia, second-degree atrioventricular node block, Mobitz Type 2, a shortened QT interval, downsloping ST depression and presence of U waves. After viewing the images of comfrey and foxglove, it highlighted the possibility of mistaken ingestion of Digitalis, containing the organic forms of cardiac glycosides, such as digoxin and digitoxin. Raised serum digoxin levels confirmed this. The patient was haemodynamically stable, and given digoxin-binding antibodies. After 5 days of cardiac monitoring, her ECG returned to normal rhythm, and she was discharged home.

Topics: Accidents; Antibodies, Heterophile; Atrioventricular Block; Bradycardia; Comfrey; Digitalis; Digoxin; Electrocardiography; Female; Humans; Middle Aged; Plant Leaves; Plant Poisoning; Plants, Medicinal; Sleep Initiation and Maintenance Disorders; Treatment Outcome; Vomiting

While digitoxicity secondary to therapeutic use is frequent, due to its distinctive appearance and unpleasant taste accidental ingestion of digitalis purpurea (foxglove) is uncommon. This report relates the case of two previously healthy individuals who inadvertently consumed significant quantities of digitalis in its plant form. Both men presented in first-degree atrioventricular block and had digoxin levels of 4.9 μg/litre, but were otherwise stable and made unremarkable recoveries with repeated dose activated charcoal.

Topics: Accidents; Adult; Atrioventricular Block; Diagnosis, Differential; Digitalis; Digoxin; Electrocardiography; Emergency Service, Hospital; Foodborne Diseases; Humans; Male; Middle Aged; Plant Poisoning; Taste

Topics: Aged; Antidotes; Atrioventricular Block; Cardiotonic Agents; Diagnosis, Differential; Digitalis Glycosides; Digitoxin; Electric Countershock; Electrocardiography; Humans; Male; Suicide, Attempted; Torsades de Pointes

Topics: Adult; Atrioventricular Block; Diet, Vegetarian; Digitalis; Electrocardiography; Emergency Service, Hospital; Humans; Male; Tea

Topics: Adult; Atrioventricular Block; Bradycardia; Comfrey; Digitalis; Digoxin; Dizziness; Electrocardiography; Humans; Male; Nausea; Phytotherapy; Plant Leaves; Vision Disorders; Vomiting

Topics: Atrioventricular Block; Digitalis; Digitalis Glycosides; Electrocardiography; Heart Block; Humans; Tachycardia; Tachycardia, Paroxysmal; Toxicology

Topics: Acetylcholine; Atrioventricular Block; Digitalis; Heart Block; Humans; Potassium

Topics: Atrioventricular Block; Digitalis; Digitalis Glycosides; Heart Block; Humans; Tachycardia

Topics: Atrioventricular Block; Cardiovascular Diseases; Digitalis; Electrocardiography; Heart Block; Humans

Topics: Atrioventricular Block; Cardiovascular Diseases; Digitalis; Heart Block; Humans; Plant Extracts

Topics: Atrioventricular Block; Child; Digitalis; Digitalis Glycosides; Humans; Plant Extracts; Quinine; Strychnine; Tablets

Topics: Atrioventricular Block; Cardiovascular Diseases; Digitalis; Heart Block; Plant Extracts; Potassium

Topics: Atrioventricular Block; Digitalis; Digitalis Glycosides; Heart Block; Humans; Tachycardia

Topics: Atrioventricular Block; Digitalis; Digitalis Glycosides; Heart Block; Humans; Tachycardia; Tachycardia, Paroxysmal

Topics: Atrioventricular Block; Cardiovascular Diseases; Digitalis; Heart Block; Humans; Potassium

Topics: Adams-Stokes Syndrome; Atrioventricular Block; Digitalis; Digitalis Glycosides; Digitoxin; Heart Block

Topics: Atrioventricular Block; Digitalis; Humans; Tachycardia; Tachycardia, Paroxysmal

Topics: Atrioventricular Block; Cardiovascular Agents; Digitalis; Drug-Related Side Effects and Adverse Reactions; Optic Neuritis