Dietary lifestyle changes unexpectedly causing digoxin intoxication with cardiogenic shock: a grand round case report

The cause of this intoxication is probably multifactorial, including reduced renal digoxin excretion, co-medication, and most likely changes in diet. We hypothesize that this dietary change not only led to substantial weight loss but also resulted in an increase of intragastric pH, thereby significantly enhancing digoxin uptake. This case underscores the importance of considering digoxin-Fabs treatment based on several factors including clinical presentation and digoxin serum levels. Furthermore, it highlights the importance of regular lifestyle anamnesis and renal function assessment to reassess digoxin dosage.