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A 55-year-old woman, a known case of chronic rheumatic heart disease with mitral stenosis and atrial fibrillation with past history of closed mitral commisurotomy 18 years ago, was admitted with complaints of nausea, vomiting and dyspnoea. A 12-lead electrocardiogram revealed absence of ‘p’ waves, bradycardia and ‘inverted check mark’ sign with inverted ‘T’ wave not rising above baseline, suggesting digoxin toxicity which was confirmed with serum digoxin …
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