Correlative studies of serum digoxin level, its clinical and electrocardiographic assessment in patients with congestive heart failure

ABSTRACT

The present work included 28 hospitalized cardiac patients [31 males and 15 females]. Their ages ranged from 17-56 years. Complete clinical examinations were performed. It was found that 16 patients had serum digoxin levels above the normal therapeutic range [2 ng/ml] with a mean + S.D. of 4.3 + 1.45. Seven of these patients showed clinical and ECG evidences of digitalis toxicity. From the 12 patients with normal serum digoxin level [Mean + S.D. 1.58 + 0.43], 2 developed ECG changes suggestive of digitalis toxicity. There was also a significant increase [P <0.05] in the serum digoxin level among hypokalemic patients as compared to normokalemic. All the hypokalemic patients showed ECG evidences of digitalis toxicity. On the other hand, no significant differences could be detected between patients with digitalis toxicity and those without as regard to the age, serum creatinine, serum potassium and digoxin level. The common ECG changes denoting digitalis toxicity were premature ventricular contraction in 66.6% and second degree heart block in 33.4% of patients