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Rare Manifestation of Digoxin Toxicity: Right Bundle Branch Block

A 76-year-old female, with medical history significant for systolic congestive heart failure, who presented to the emergency department with lethargy and abdominal pain with diarrhea for the past 3 weeks. Due to hypotension, the patient received multiple boluses of isotonic saline and was started on...

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Detalles Bibliográficos
Autores principales: Gill, Dalvir, Zaidi, Samana
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Medknow Publications & Media Pvt Ltd 2016
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5201064/
https://www.ncbi.nlm.nih.gov/pubmed/28104974
http://dx.doi.org/10.4103/0976-0105.195128
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author Gill, Dalvir
Zaidi, Samana
author_facet Gill, Dalvir
Zaidi, Samana
author_sort Gill, Dalvir
collection PubMed
description A 76-year-old female, with medical history significant for systolic congestive heart failure, who presented to the emergency department with lethargy and abdominal pain with diarrhea for the past 3 weeks. Due to hypotension, the patient received multiple boluses of isotonic saline and was started on norepinephrine. Laboratories were significant for severe digoxin toxicity (29 ng/mL), in setting of acute kidney injury. Electrocardiogram (EKG) revealed a new right bundle branch block (RBBB). She was given Digibind and her repeat digoxin level was 20 ng/mL. Repeat EKG showed resolved RBBB. This case identifies that patients with digoxin toxicity are at risk for RBBB. This is a rare finding and is not commonly recognized. Emergency medicine physicians are often the first to encounter patients with digoxin toxicity and need to be aware of such EKG findings.
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spelling pubmed-52010642017-01-19 Rare Manifestation of Digoxin Toxicity: Right Bundle Branch Block Gill, Dalvir Zaidi, Samana J Basic Clin Pharm Case Report A 76-year-old female, with medical history significant for systolic congestive heart failure, who presented to the emergency department with lethargy and abdominal pain with diarrhea for the past 3 weeks. Due to hypotension, the patient received multiple boluses of isotonic saline and was started on norepinephrine. Laboratories were significant for severe digoxin toxicity (29 ng/mL), in setting of acute kidney injury. Electrocardiogram (EKG) revealed a new right bundle branch block (RBBB). She was given Digibind and her repeat digoxin level was 20 ng/mL. Repeat EKG showed resolved RBBB. This case identifies that patients with digoxin toxicity are at risk for RBBB. This is a rare finding and is not commonly recognized. Emergency medicine physicians are often the first to encounter patients with digoxin toxicity and need to be aware of such EKG findings. Medknow Publications & Media Pvt Ltd 2016-12 /pmc/articles/PMC5201064/ /pubmed/28104974 http://dx.doi.org/10.4103/0976-0105.195128 Text en Copyright: © Journal of Basic and Clinical Pharmacy http://creativecommons.org/licenses/by-nc-sa/3.0 This is an open access article distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 3.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as the author is credited and the new creations are licensed under the identical terms.
spellingShingle Case Report
Gill, Dalvir
Zaidi, Samana
Rare Manifestation of Digoxin Toxicity: Right Bundle Branch Block
title Rare Manifestation of Digoxin Toxicity: Right Bundle Branch Block
title_full Rare Manifestation of Digoxin Toxicity: Right Bundle Branch Block
title_fullStr Rare Manifestation of Digoxin Toxicity: Right Bundle Branch Block
title_full_unstemmed Rare Manifestation of Digoxin Toxicity: Right Bundle Branch Block
title_short Rare Manifestation of Digoxin Toxicity: Right Bundle Branch Block
title_sort rare manifestation of digoxin toxicity: right bundle branch block
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5201064/
https://www.ncbi.nlm.nih.gov/pubmed/28104974
http://dx.doi.org/10.4103/0976-0105.195128
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