A 64 year old lady on digoxin

Digitalis effect

• shortened QT interval
• characteristic down-sloping ST depression, reverse tick appearence, (shown here in leads V5 and V6)
• dysrhythmias
  • ventricular / atrial premature beats
  • paroxysmal atrial tachycardia with variable AV block
  • ventricular tachycardia and fibrillation
  • many others