Reactions 1455 - 8 Jun 2013

SDigoxin

Digoxin toxicity and Tako-Tsubo cardiomyopathy inan elderly patient: case report

An 83-year-old woman developed Tako-Tsubocardiomyopathy (TTC) that was possibly triggered by digoxintoxicity [details of digoxin administration not stated].

The woman, who had a history of hypertension, diabetes,chronic kidney disease and chronic atrial fibrillation, wasreferred for acute abdominal pain and diarrhoea. One weeklater, she reported dyspnoea, and ECG revealed atrialfibrillation, a low ventricular rate, a left anterior hemi-blockand negative T waves. Tests showed a digoxin concentration of2.6 ng/mL (therapeutic range 0.9–2 ng/mL), a cardiactroponin I level of 1.58 ng/mL and acute renal failure.Echocardiography findings included features resembling apicalballooning, typical of TTC. She gradually recovered, and wasdischarged after all of her symptoms resolved.

Author comment: "We therefore hypothesize that acuterenal failure a consequent digoxin toxicity and brady-arrhythmias could be related to increased levels ofcatecholamines responsible for the clinical onset of TTC."Santoro F, et al. Acute renal failure, digoxin toxicity and brady-arrhythmia aspossible triggers in Tako-Tsubo cardiomyopathy. International Journal ofCardiology 165: e51-e52, No. 3, 25 May 2013. Available from: URL: http://dx.doi.org/10.1016/j.ijcard.2012.11.015 - Italy 803087963

» Editorial comment: Details of a second patient from thisreport have previously been published [see Reactions 1453 p19;803087316].

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Reactions 8 Jun 2013 No. 14550114-9954/10/1455-0001/$14.95 Adis © 2010 Springer International Publishing AG. All rights reserved