[Can peak serum digoxin concentration be a sign of acute poisoning severity? Analysis of two cases of digoxin poisoning].

Contrary to cardiac glycoside poisoning often seen in medical practice, intentional digoxin poisoning is rather rare and its course is serious only if very high doses have been ingested. Ventricular arrhythmias and severe conduction disturbances are the most threatening sings may need the use of antiarrhythmic agents, temporally endocardial stimulation or digoxin specific antibody Fab fragments. The course and the management of digitalis poisoning is described in two young patients (female aged 37 and male aged 26). Before admission to the hospital they were healthy, without any heart problem. Only one patient (female) had short spell of nausea and vomiting as well as green vision phenomenon. This patient developed transitory non-life threatening conduction disturbances (degree and II degree a-v block). The second patient had nausea and vomiting but no serious cardiac symptoms. In both patients very high digoxin plasma levels were found (19.88 ng/ml and 9.63 ng/ml), but no one of them had serious poisoning symptoms and did not require any specific therapy. After 3 (male) and 4 (female) days both patients left the hospital.