PT  - JOURNAL ARTICLE
AU  - Lara Delicata
AU  - Arlène Gatt
AU  - Jean-Luc Paris
AU  - John Bonello
TI  - Symptomatic digoxin toxicity in a patient on haemodialysis
AID  - 10.1136/bcr-2020-234899
DP  - 2020 Jun 01
TA  - BMJ Case Reports
PG  - e234899
VI  - 13
IP  - 6
4099  - http://casereports.bmj.com/content/13/6/e234899.short
4100  - http://casereports.bmj.com/content/13/6/e234899.full
SO  - BMJ Case Reports2020 Jun 01; 13
AB  - We present a man undergoing regular haemodialysis sessions, who presented with non-specific symptoms of nausea, vomiting and light-headedness. He was found to have significantly raised serum digoxin concentrations, as well as a heart rate of 30 beats per minutes. An ECG showed complete heart block. He has a history of non-ischaemic dilated cardiomyopathy with resistant supraventricular and ventricular tachycardias and was on concomitant beta-blockade and digoxin. On questioning, he reported a gradual decline in his residual urine output over the past 6 months. He was reviewed by the cardiology team and required both pharmacological therapy for reversal of digoxin toxicity and temporary pacing in view of significant bradyarrhythmias. The beta-blockade and digoxin were discontinued. He was kept on continuous monitoring at the Cardiac Critical Care Unit. His symptoms resolved spontaneously once digoxin-specific antibody fragments were administered and temporary pacing successfully performed.