A 77-year-old woman with heart failure and chronic kidney disease presents with nausea, yellow-tinted vision, and palpitations. Vital signs: BP 98/62 mmHg, HR 140/min, RR 20/min, temp 37.2°C, SpO2 98% on room air. ECG shows bidirectional ventricular tachycardia. Serum potassium is 4.2 mEq/L. She denies chest pain. She takes digoxin 0.25 mg daily. Which medication toxicity best explains this arrhythmia?
- A)Hypocalcemia causing prolonged QT interval
- B)Acute pericarditis causing atrial irritability
- C)Digoxin toxicity causing delayed afterdepolarizationsGABARITO
- D)Congenital sodium channel mutation in Brugada syndrome
- E)Accessory pathway conduction in Wolff-Parkinson-White syndrome
Explicação
Digoxin toxicity can cause a variety of arrhythmias, including bidirectional ventricular tachycardia, due to increased intracellular calcium and delayed afterdepolarizations. Nausea, xanthopsia, renal dysfunction, and arrhythmia strongly point to digoxin toxic... Ver explicação completa e trilha adaptativa →