Which finding is included in signs and symptoms for digitalis toxicity?

• A. Pulse below 60 beats/min and irregular rate
• B. Pulse (heart) rate of 100 beats/min
• C. Pulse 72 with an irregular rate
• D. Pulse greater than 60 beats/min and irregular rate

Answer: (A)

Digitalis toxicity most clearly shows up as bradycardia with possible irregular rhythms. Digoxin increases vagal tone and slows conduction through the AV node, which lowers the heart rate. Toxic levels can also provoke various conduction disturbances, leading to an irregular pulse. So a pulse below 60 beats per minute with an irregular rate is the hallmark cardiovascular sign of digitalis toxicity. While toxicity can cause other rhythm changes, a slowed, irregular pulse is the most consistent and recognizable finding. The other options describe a faster heart rate or a normal/fast rhythm with irregularity, which are less typical of the classic toxicity pattern.