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Post-mortem digoxin levels--two unusual case reports

S J Dickson, N D Blazey

    Forensic Science
    |March 1, 1977
    PubMed
    Summary
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    This study reports on two unique post-mortem digoxin level cases. One case showed exceptionally high blood digoxin levels, five times greater than previously documented.

    Area of Science:

    • Forensic Toxicology
    • Clinical Chemistry

    Background:

    • Digoxin is a cardiac glycoside used to treat heart failure and arrhythmias.
    • Accurate quantification of digoxin levels is crucial for clinical and forensic applications.
    • Post-mortem digoxin analysis presents unique challenges due to potential post-mortem redistribution and degradation.

    Observation:

    • This report details two unusual cases involving digoxin level determination in post-mortem specimens.
    • Case 1 involved exceptionally high digoxin blood levels, significantly exceeding previously reported values.
    • Case 2 presented challenges due to the analysis of digoxin in an embalmed body specimen.

    Findings:

    • The blood digoxin concentration in Case 1 was approximately five times higher than any previously recorded level.

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  • Analysis of digoxin in embalmed tissue (Case 2) demonstrated the feasibility of testing under such conditions.
  • These findings highlight the variability and potential for extreme levels of digoxin in post-mortem scenarios.

    • Implications:

    • The findings necessitate a review of established reference ranges for post-mortem digoxin levels.
    • This study underscores the importance of considering specimen condition (e.g., embalming) in toxicological analysis.
    • Further research is warranted to understand the mechanisms behind extremely high post-mortem digoxin concentrations and their interpretation.