AAEM/RSA Blog - MAY 8, 2016 - Author: Andrew V. Bokarius
"The Bottom Line
The fear of calcium use in digoxin toxicity with hyperkalemia seems unfounded but the evidence is limited, especially in acute toxicity. The idea of “stone heart” from calcium is likely just a myth; however, it should be noted that calcium is not the optimal treatment in these cases. Rather than likening calcium to Medusa’s stone-turning powers, treatment should focus on the real problem—the digoxin toxicity. Nevertheless, in a patient with
unknown digoxin use and hyperkalemia, calcium should be used in the standard fashion. For digoxin toxicity, order digoxin immune fab, monitor and support your patient, and don’t get caught up in the idea of a mythical stone heart."