Digoxin toxicity presentations

I came across a patient few days ago, 80 year old M with CCF on digoxin presented with an episode of sudden onset of dizziness lasting for around 3-4 minutes. The patient worried about digoxin toxicity. I used this opportunity to remind myself on the signs and symptoms of digoxin toxicity.

We can divide digoxin toxicity into acute or chronic:

Acute:
- GI: anorexin, vomiting, nausea, diarrhoea and abdominal pain
- Metabolic: hyperkalaemia (early sign of significant toxicity)
- CNS: enhanced automaticity with AV block, VF, VT, ventricular ectopic beats, bradyarrhythmias, hypotension and shock
- CNS: lethargy and confusion

Chronic digoxin toxicity:

Other features of chronic toxicity commonly described in textbooks are visual disturbances (e.g. reduce acuity, yellow halos (xanthopsia) and altered color perception (chromatopsia)}

Reference:

http://lifeinthefastlane.com/ccc/digoxin-toxicity/