R. H. Ravikumar, Baby Pegu, Himanti Bansal, K. Soni
{"title":"陷入复杂局面:一例洋地黄引发的跌倒、外伤、症状性心动过缓和晕厥病例","authors":"R. H. Ravikumar, Baby Pegu, Himanti Bansal, K. Soni","doi":"10.4103/jfmpc.jfmpc_1850_23","DOIUrl":null,"url":null,"abstract":"ABSTRACT\n \n Digoxin, a cardiac glycoside, functions by inhibiting the sodium potassium ATPase pump. It’s crucial to note that digoxin has a very narrow therapeutic range. Its serum level vary due to changes in body weight, age, renal function, hepatic impairment and concomitant drug therapy. Chronic toxicity can lead to different types of arrrythmia,which span from heart blocks to ventricular tachycardia.This report present a case of an elderly male, where Digoxin toxicity resulted in syncope and mild traumatic brain injury. Initially upon patient’s presentation ECG indicated myocardial infarction, subsequently bradycardia and complete heart block. The patient had a known history of chronic kidney disease and was prescribed 0.25mg of digoxin regularly without dose adjustment, which might have resulted in reduced digoxin elimination, leading to toxicity. Thus this case demonstrates a classic presentation of digoxin toxicity. Multiple risk factor such as old age, impaired renal function with continued digoxin treatment without dose adjustment was likely the cause of toxicity.","PeriodicalId":15856,"journal":{"name":"Journal of Family Medicine and Primary Care","volume":null,"pages":null},"PeriodicalIF":1.1000,"publicationDate":"2024-07-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Falling into complexity: A case of digitalis-induced fall, trauma, symptomatic bradycardia, and syncope\",\"authors\":\"R. H. Ravikumar, Baby Pegu, Himanti Bansal, K. Soni\",\"doi\":\"10.4103/jfmpc.jfmpc_1850_23\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"ABSTRACT\\n \\n Digoxin, a cardiac glycoside, functions by inhibiting the sodium potassium ATPase pump. It’s crucial to note that digoxin has a very narrow therapeutic range. Its serum level vary due to changes in body weight, age, renal function, hepatic impairment and concomitant drug therapy. Chronic toxicity can lead to different types of arrrythmia,which span from heart blocks to ventricular tachycardia.This report present a case of an elderly male, where Digoxin toxicity resulted in syncope and mild traumatic brain injury. Initially upon patient’s presentation ECG indicated myocardial infarction, subsequently bradycardia and complete heart block. The patient had a known history of chronic kidney disease and was prescribed 0.25mg of digoxin regularly without dose adjustment, which might have resulted in reduced digoxin elimination, leading to toxicity. Thus this case demonstrates a classic presentation of digoxin toxicity. Multiple risk factor such as old age, impaired renal function with continued digoxin treatment without dose adjustment was likely the cause of toxicity.\",\"PeriodicalId\":15856,\"journal\":{\"name\":\"Journal of Family Medicine and Primary Care\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":1.1000,\"publicationDate\":\"2024-07-26\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of Family Medicine and Primary Care\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.4103/jfmpc.jfmpc_1850_23\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q4\",\"JCRName\":\"PRIMARY HEALTH CARE\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Family Medicine and Primary Care","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.4103/jfmpc.jfmpc_1850_23","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q4","JCRName":"PRIMARY HEALTH CARE","Score":null,"Total":0}
引用次数: 0
摘要
摘要 地高辛是一种强心苷,通过抑制钠钾 ATP 酶泵发挥作用。值得注意的是,地高辛的治疗范围很窄。其血清水平会因体重、年龄、肾功能、肝功能损害和伴随药物治疗的变化而变化。慢性中毒可导致不同类型的心律失常,包括心脏传导阻滞和室性心动过速。本报告介绍了一例老年男性地高辛中毒导致晕厥和轻度脑外伤的病例。患者最初的心电图显示为心肌梗死,随后出现心动过缓和完全性心脏传导阻滞。患者已知有慢性肾脏病史,且定期服用 0.25 毫克地高辛而未调整剂量,这可能导致地高辛排出减少,从而导致中毒。因此,本病例是地高辛中毒的典型表现。多种危险因素(如高龄、肾功能受损、持续服用地高辛而不调整剂量)可能是导致中毒的原因。
Falling into complexity: A case of digitalis-induced fall, trauma, symptomatic bradycardia, and syncope
ABSTRACT
Digoxin, a cardiac glycoside, functions by inhibiting the sodium potassium ATPase pump. It’s crucial to note that digoxin has a very narrow therapeutic range. Its serum level vary due to changes in body weight, age, renal function, hepatic impairment and concomitant drug therapy. Chronic toxicity can lead to different types of arrrythmia,which span from heart blocks to ventricular tachycardia.This report present a case of an elderly male, where Digoxin toxicity resulted in syncope and mild traumatic brain injury. Initially upon patient’s presentation ECG indicated myocardial infarction, subsequently bradycardia and complete heart block. The patient had a known history of chronic kidney disease and was prescribed 0.25mg of digoxin regularly without dose adjustment, which might have resulted in reduced digoxin elimination, leading to toxicity. Thus this case demonstrates a classic presentation of digoxin toxicity. Multiple risk factor such as old age, impaired renal function with continued digoxin treatment without dose adjustment was likely the cause of toxicity.