Digitoxin Causing Ventricular Tachycardia With Peripheral Vascular Collapse

The widespread use of digitoxin in this country is undoubtedly due to its advantages, so convincingly demonstrated by Gold and associates,¹of (1) rapid and almost complete absorption from the gastrointestinal tract, (2) insignificant systemic toxicity in terms of nausea and vomiting and (3) resultant ease with which it lends itself to rapid digitalization with multiple or single oral dosage. The possibility of cardiac toxicity, however, appears to be insufficiently emphasized by those advocating use of digitoxin for rapid single dose digitalization. Their only recently repeated recommendation1ethat "an average full digitalizing dose of 1.2 mg. may besafelygivenat one timeto patients who have not recently had digitalis" (italics ours) makes no allowance for the possibility of serious cardiac toxicity. Reports on the toxic effects of digitoxin on the heart by other observers²have only recently made their appearance in the literature. We should