Skip to main content
NCBI home page
British Heart Journal logoLink to British Heart Journal
. 1977 Sep;39(9):1029–1032. doi: 10.1136/hrt.39.9.1029

Intracellular electrolytes in cardiac and skeletal muscle in fatal digitalis intoxication.

T Dyckner, U de Faire, P O Wester
PMCID: PMC483364  PMID: 907768

Abstract

Samples from cardiac and skeletal muscle were obtained immediately after death in a case of fatal digitalis intoxication. Intra- and extracellular electrolytes were determined by atomic absorption spectrophotometry. No changes were found in the extracellular electrolytes, and only modest changes were noted in skeletal muscle. In cardiac muscle, however, profound electrolyte disturbances were recorded with an inward shift of sodium and an outward shift fo potassium. This signifies an extensive and early inhibition of the membrane ATPase in cardiac muscle and stresses the importance of immediate and vigorous treatment of the intracellular electrolyte disturbances with a view to suppressing serious and potentially lethal arrhythmias.

Full text

PDF
1029

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. BONTING S. L., CARAVAGGIO L. L., HAWKINS N. M. Studies on sodium-potassium-activated adenosinetriphosphatase. IV. Correlation with cation transport sensitive to cardiac glycosides. Arch Biochem Biophys. 1962 Sep;98:413–419. doi: 10.1016/0003-9861(62)90206-0. [DOI] [PubMed] [Google Scholar]
  2. Beck O. A., Krämer K. D., Hochrein H. Verlauf einer suizidalen Digoxin-Intoxikation mit Hyperkaliämie. Klinische Beobachtung auf einer internen Intensivstation. Dtsch Med Wochenschr. 1974 Apr 12;99(15):756–764. doi: 10.1055/s-0028-1107839. [DOI] [PubMed] [Google Scholar]
  3. Bismuth C., Gaultier M., Conso F., Efthymiou M. L. Hyperkalemia in acute digitalis poisoning: prognostic significance and therapeutic implications. Clin Toxicol. 1973;6(2):153–162. doi: 10.3109/15563657308990513. [DOI] [PubMed] [Google Scholar]
  4. Buchanan J. Self-poisoning with digitalis glycosides. Br Med J. 1967 Sep 9;3(5566):661–662. doi: 10.1136/bmj.3.5566.661. [DOI] [PMC free article] [PubMed] [Google Scholar]
  5. CONWAY E. J. Nature and significance of concentration relations of potassium and sodium ions in skeletal muscle. Physiol Rev. 1957 Jan;37(1):84–132. doi: 10.1152/physrev.1957.37.1.84. [DOI] [PubMed] [Google Scholar]
  6. Doherty J. E., Perkins W. H., Flanigan W. J. The distribution and concentration of tritiated digoxin in human tissues. Ann Intern Med. 1967 Jan;66(1):116–124. doi: 10.7326/0003-4819-66-1-116. [DOI] [PubMed] [Google Scholar]
  7. Graham J. A., Lamb J. F., Linton A. L. Measurement of body water and intracellular electrolytes by means of muscle biopsy. Lancet. 1967 Dec 2;2(7527):1172–1176. doi: 10.1016/s0140-6736(67)91892-2. [DOI] [PubMed] [Google Scholar]
  8. Kleiger R., Lown B. Cardioversion and digitalis. II. Clinical studies. Circulation. 1966 Jun;33(6):878–887. doi: 10.1161/01.cir.33.6.878. [DOI] [PubMed] [Google Scholar]
  9. LOWN B., BLACK H., MOORE F. D. Digitalis, electrolytes and the surgical patient. Am J Cardiol. 1960 Aug;6:309–337. doi: 10.1016/0002-9149(60)90320-9. [DOI] [PubMed] [Google Scholar]
  10. LOWN B., LEVINE S. A. Current concepts in digitalis therapy. N Engl J Med. 1954 May 6;250(18):771–contd. doi: 10.1056/NEJM195405062501806. [DOI] [PubMed] [Google Scholar]
  11. Langer G. A. Effects of digitalis on myocardial ionic exchange. Circulation. 1972 Jul;46(1):180–187. doi: 10.1161/01.cir.46.1.180. [DOI] [PubMed] [Google Scholar]
  12. Lim P., Jacob E. Magnesium deficiency in patients on long-term diuretic therapy for heart failure. Br Med J. 1972 Sep 9;3(5827):620–622. doi: 10.1136/bmj.3.5827.620. [DOI] [PMC free article] [PubMed] [Google Scholar]
  13. Lown B., Kleiger R., Williams J. Cardioversion and digitalis drugs: changed threshold to electric shock in digitalized animals. Circ Res. 1965 Dec;17(6):519–531. doi: 10.1161/01.res.17.6.519. [DOI] [PubMed] [Google Scholar]
  14. MCNAMARA D. G., BREWER E. J., Jr, FERRY G. D. ACCIDENTAL POISONING OF CHILDREN WITH DIGITALIS. N Engl J Med. 1964 Nov 19;271:1106–1108. doi: 10.1056/NEJM196411192712108. [DOI] [PubMed] [Google Scholar]
  15. Mason D. T., Braunwald E. Digitalis: new facts about an old drug. Am J Cardiol. 1968 Aug;22(2):151–161. doi: 10.1016/0002-9149(68)90220-8. [DOI] [PubMed] [Google Scholar]
  16. PAGE E. THE ACTIONS OF CARDIAC GLYCOSIDES ON HEART MUSCLE CELLS. Circulation. 1964 Aug;30:237–251. doi: 10.1161/01.cir.30.2.237. [DOI] [PubMed] [Google Scholar]
  17. Rosen M. R., Gelband H., Hoffman B. F. Correlation between effects of ouabain on the canine electrocardiogram and transmembrane potentials of isolated Purkinje fibers. Circulation. 1973 Jan;47(1):65–72. doi: 10.1161/01.cir.47.1.65. [DOI] [PubMed] [Google Scholar]
  18. Smith T. W., Butler V. P., Jr, Haber E. Determination of therapeutic and toxic serum digoxin concentrations by radioimmunoassay. N Engl J Med. 1969 Nov 27;281(22):1212–1216. doi: 10.1056/NEJM196911272812203. [DOI] [PubMed] [Google Scholar]
  19. Smith T. W., Willerson J. T. Suicidal and accidental digoxin ingestion. Report of five cases with serum digoxin level correlations. Circulation. 1971 Jul;44(1):29–36. doi: 10.1161/01.cir.44.1.29. [DOI] [PubMed] [Google Scholar]
  20. Steentoft A. Fatal digitalis poisoning. Acta Pharmacol Toxicol (Copenh) 1973;32(5):353–357. doi: 10.1111/j.1600-0773.1973.tb01481.x. [DOI] [PubMed] [Google Scholar]
  21. Szekely P. THE ACTION OF MAGNESIUM ON THE HEART. Br Heart J. 1946 Jul;8(3):115–124. [PMC free article] [PubMed] [Google Scholar]

Articles from British Heart Journal are provided here courtesy of BMJ Publishing Group

RESOURCES