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Digoxin Toxicity Awareness: When Fatigue isn’t what You Think

Melissa Rae LeBlanc, Emma Pieris, Michelle Thompson

Use of digoxin, a cardiac glycoside, has reduced over the last two decades, as have rates of hospitalization for digoxin toxicity. Decreased use of digoxin and concurrent decrease in the incidence of toxicity has led to decreased awareness and recognition of this toxicity which may delay treatment with digoxin immune fab, increasing morbidity and mortality. We present a case of an elderly gentleman with digoxin toxicity who presented with fatigue, diffuse weakness, AKI, hyperkalemia, atrial tachycardia with intermittent AV nodal block, ventricular ectopy and slow ventricular response to atrial fibrillation, who responded to treatment with digoxin immune fab with resolution of symptoms.