Digitalis: a drug that refuses to die.

Abstract

Use of digitalis declined in the 1970s, especially among younger physicians, but several recent studies have conclusively documented the hemodynamic and symptomatic benefits of digitalis in patients with class III and IV heart failure resulting from left ventricular systolic dysfunction. The S3 gallop is a useful marker for a subset with a highly favorable response. Symptomatic benefit cannot be shown in most patients with class I and II heart disease (e.g., most myocardial infarction patients). When patients are monitored carefully for evidence of toxicity with serum digitalis assays and for factors that may affect drug bioavailability or clearance, digitalis is well tolerated.