Digitalis Intoxication

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Abstract
A prospective study of 931 consecutive patients admitted to a medical service was undertaken to describe the prevalence and epidemiology of cardiac digitalis toxicity, and to correlate serum concentrations of digoxin and digitoxin by radioimmunoassay with clinical and biochemical data. Fifteen per cent of the patients surveyed were taking digitalis on admission, and of these, 23 per cent were definitely and 6 per cent possibly digitalis toxic by serial electrocardiograms. There was a significantly greater prevalence of advanced heart disease, underlying atrial fibrillation, anorexia, acute or chronic pulmonary disease and renal failure in toxic than in nontoxic patients. Mortality was more than twice as high in the toxic group. Serum drug concentrations were significantly higher in toxic than in nontoxic patients. This study of patients entering a large city hospital demonstrated a high prevalence of digitalis intoxication, which had an ominous prognosis.

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