Intoxication by Digitalis Purpurea in Suicidal Intention – a Case Report

We report a case of a 27 year old female with a known progressive major depression, who ingested an unknown amount of leaves of Digitalis purpurea (Figure 1) for attempted suicide. The patient developed nausea, emesis and a reduction of color vision. Furthermore, the ECG showed atrioventricular block II° (Wenckebach, Mobitz) with the necessity of pacemaker implantation. The therapeutic range of digitalis compounds are narrowed by the toxic side effects due to interindividual variability of the pharmacologic impact and may be accompanied by potentially life-threatening outcomes. The intoxication by Digitalis purpurea is a potentially life-threatening serious adverse event and requires an ICU monitoring. The diagnosis of intoxication by digitalis derivates is a demanding issue due to the various and often unspecific clinical symptoms and ECG manifestations. The underlying diseases, however, may lead to comparable symptoms and ECG manifestations without the possibility of prompt distinction. Due to the different composition of glycosides, their different half-time values and different cross-reactivity features to common assays, the clinical course, the extent of the severity of symptoms and long-term ECG monitoring represent the adequate method of surveillance and treatment control.