Case history
Case history #1
An 86-year-old woman presents with confusion and vomiting. She complains of weakness, nausea, and decreased appetite. Her history is significant for congestive heart failure for which she takes, among other medications, digoxin. In the hospital, she is alert and oriented in person, but not in time or place. Vital signs are normal except for a heart rate of 56 bpm. Her physical examination demonstrates bibasilar rales, irregular S1, S2 with an S3 gallop, and bilateral lower extremity 2+ pitting edema up to her shins.
Case history #2
A 19-year-old woman presents approximately 30 minutes after ingesting 30 of her grandmother's 0.25 mg digoxin tablets in a suicide attempt. In the hospital, her vital signs are normal. She is in no acute distress and has no complaints; physical examination is within expected limits. About 30 minutes after arrival, she complains of nonspecific abdominal pain and starts vomiting.
Use of this content is subject to our disclaimer