digoxin and Hypercalcemia

The cardiac effects of hypercalcaemia are usually manifest as a shortening of the QT-interval. Hypercalcaemia is infrequently associated with a clinically manifest arrhythmia. However, concomitant therapy with digoxin or underlying cardiac disease can potentiate the arrhythmogenic effects of hypercalcaemia, leading to a symptomatic rhythm disorder. We describe a symptomatic arrhythmia, which developed in a patient with hypercalcaemia secondary to squamous cell carcinoma of the bronchus. The patient was on digoxin therapy at the time. The arrhythmia did not recur after discontinuation of digoxin therapy and correction of the hypercalcaemia. Because of its effect on cardiac conduction, hypercalcaemia should be considered in the evaluation of any patient with an unexplained bradyarrhythmia. Conversely, patients with hypercalcaemia should discontinue digoxin therapy and be evaluated for the presence of rhythm disorders while receiving appropriate treatment for hypercalcaemia.

Topics: Aged; Aged, 80 and over; Anti-Arrhythmia Agents; Bradycardia; Bronchial Neoplasms; Carcinoma, Squamous Cell; Contraindications; Digoxin; Female; Humans; Hypercalcemia

Topics: Age Factors; Calcium; Digitalis Glycosides; Digitoxin; Digoxin; Drug Interactions; Humans; Hypercalcemia; Hypokalemia; Intestinal Absorption; Methods; Potassium; Saliva; Suicide

Topics: Age Factors; Creatinine; Diet; Digitalis; Digitalis Glycosides; Digitoxin; Digoxin; Diuretics; Heart Failure; Humans; Hypercalcemia; Hypokalemia; Kidney; Kinetics; Liver; Magnesium; Ouabain; Plants, Medicinal; Plants, Toxic; Rest; Thyroid Gland; Time Factors

Topics: Acute Disease; Arrhythmias, Cardiac; Bradycardia; Digoxin; Electrocardiography; Humans; Hypercalcemia; Male; Middle Aged; Nausea; Suicide; Vomiting

Topics: Adult; Diagnosis, Differential; Digitalis Glycosides; Digoxin; Electrocardiography; Endocarditis, Subacute Bacterial; Female; Humans; Hypercalcemia; Hyperkalemia; Prednisone; Rheumatic Heart Disease; Substance-Related Disorders

Topics: Arrhythmia, Sinus; Calcium; Digoxin; Female; Heart Block; Humans; Hypercalcemia; Hyperthyroidism; Middle Aged; Procainamide