Ver el código de «Stone heart»

==Background==
*Administration of intravenous [[calcium chloride|calcium]] thought to be contraindicated in patients with [[Digoxin Toxicity|digitalis toxicity]] based on 1936 case report<ref>Bower JO ,Mengle HAK. The additive effect of calcium and digitalis. JAMA 1936;106(14):1151–1153.</ref>
*It was theorized in case report that calcium may cause an irreversible non-contractile state by impairing diastolic relaxation from calcium-[[troponin]] C binding in the presence of Na/K channel blockade by Digoxin<ref>Erickson CP, Olson KR. Case files of the medical toxicology fellowship of the California poison control system-San Francisco: calcium plus digoxin-more taboo than toxic? J Med Toxicol. 2008;4(1):33-39. [http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3550094/pdf/13181_2009_Article_BF03160949.pdf FullText]</ref>
*Excess calcium may also predispose to [[arrhythmias]] by adversely affecting re-polarization

==Current Literature==
*Patients with  digoxin toxicity who given calcium do not have a statistically significant increase in mortality (22% versus 20%)<ref>Levine M, Nikkanen H, Pallin DJ. The effects of intravenous calcium in patients with digoxin toxicity. J Emerg Med. 2011 Jan;40(1):41-6 [http://www.emergencymedicine.utoronto.ca/Assets/EmergeMed%20Digital%20Assets/event/Journal%20Club/The%20Effects%20of%20Intravenous%20Calcium%20in%20Patients%20with%20Digoxin%20Toxicity.pdf FullText]</ref>
*A 2003 case report describes positive benefit from treating hyperkalemia in the setting of digitalis toxicity<ref>Van Deusen SK, et al. Treatment of hyperkalemia in a patient with unrecognized digitalis toxicity J Toxicol Clin Toxicol 2003;41:373-376.</ref>

==External Links==
*[http://lifeinthefastlane.com/ccc/calcium-digoxin-toxicity-and-stone-heart-theory/ LITFL - Calcium and Digoxin]
*[http://www.edtcc.com/blog/2012/1/13/myth-buster-episode-4-the-case-of-the-stone-heart.html Myth Buster - Stone Heart]

==See Also==
*[[Digitalis Toxicity]]
*[[Digoxin]]
*[[Electrolyte Abnormalities (Main)| Electrolyte Abnormalities]]

==References==
{{Reflist|2}}

[[Category:Cardiology]][[Category:Toxicology]]