What are the manifestations of digoxin toxicity?

Digoxin is a cardiac glycoside used to enhance myocardial contractility and treat heart failure. It is widely utilized in clinical practice, particularly in cardiology. However, the therapeutic dose of digoxin is very close to its toxic dose, resulting in a narrow safety margin. Inter-individual variability is substantial—especially among elderly patients with heart failure—making them particularly susceptible to digoxin toxicity even with minor dosing errors.

The most critical manifestation of digoxin toxicity is various types of arrhythmias; severe cases may progress to cardiac arrest or sudden death. Gastrointestinal adverse effects—including nausea, vomiting, diarrhea, and anorexia—are also common, as are systemic symptoms such as dizziness and fatigue. Some patients may experience visual disturbances, including blurred vision, xanthopsia (yellow-tinted vision), or chloropsia (green-tinted vision).Neurological adverse effects—including headache, insomnia, mental status changes, and seizures—may also occur.