TY - JOUR T1 - Symptomatic digoxin toxicity in a patient on haemodialysis JF - BMJ Case Reports JO - BMJ Case Reports DO - 10.1136/bcr-2020-234899 VL - 13 IS - 6 SP - e234899 AU - Lara Delicata AU - Arlène Gatt AU - Jean-Luc Paris AU - John Bonello Y1 - 2020/06/01 UR - http://casereports.bmj.com/content/13/6/e234899.abstract N2 - 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. ER -