What are late signs of digoxin toxicity?

• A. Hypertension
• B. Arrhythmias
• C. Nausea
• D. Dizziness

Answer: (B)

Late signs of digoxin toxicity are primarily cardiac rhythm disturbances. As toxicity progresses, digoxin’s effects on conduction and automaticity of the heart can produce dangerous arrhythmias, with bradycardia and various blocks being common late manifestations. A classic pattern is an atrial tachycardia with block, but any significant arrhythmia can occur and poses a serious risk.

Nausea and dizziness are more typical earlier symptoms from the GI and CNS effects of digoxin, not late signs. Hypertension isn’t a usual feature of digoxin toxicity. When arrhythmias appear, it signals a need for urgent evaluation and management, including stopping digoxin, correcting electrolytes, and considering digoxin-specific antibody (Fab) therapy in severe cases.