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Digitalis Toxicity and Hypomagnesemia.

Robert H. Seller, M.D., F.A.C.P.; Jose Cangiano, M.D.; Kwan Kim, M.D.; Charles Swartz, M.D.; and Albert N. Brest, M.D., F.A.C.P.
Ann Intern Med. 1968;68(5):1161. doi:10.7326/0003-4819-68-5-1161_1
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Four patients with digitalis toxicity were found to be hypomagnesemic and normokalemic. Subsequently we observed a significantly lower mean serum magnesium in a group of digitalized heart failure patients (1.40 mEq/liter) than in matched normals (1.93m Eq/liter). These observations, coupled with the fact that both digitalis and magnesium deficiency lead to a decrease in intracellular potassium, suggested that hypomagnesemia might contribute to the development of digitalis toxicity.

To determine whether hypomagnesemia facilitates the development of digitalis toxicity and to determine the efficacy of intravenous magnesium sulfate in the treatment of hypomagnesemic digitalis toxicity, serial acetylstrophanthidin infusions were performed in 19


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