2. What are the signs and symptoms of digoxin toxicity?

The most common symptoms are gastrointestinal and include nausea, vomiting, abdominal pain and diarrhea.

The cardiac manifestations are the most concerning and can be life-threatening. Digoxin toxicity can induce literally every arrhythmia, except for rapidly conducted atrial arrhythmias (atrial fibrillation or atrial flutter with ventricular rates > 100). Cardiac arrest and death can occur.

Neurological symptoms, including altered mental status, can occur even without hypoperfusion of the brain. Ocular manifestation includes xanthopsia (seeing yellow). Most experts believe that the famous artist Vincent van Gogh was using foxglove (the flower that digoxin is derived from), and this explains his yellow paintings toward the end of his life.