The systemic effects of digoxin toxicity have been well-known. However, there has been no case citing the effects of intrathecal digoxin in light of end-stage renal disease in the elderly. Here, we report on the case of the successful management of accidental intrathecal digoxin administration in an elderly male with end-stage renal disease.

Objective: The aim of this study is to calculate cardiovascular risk (CVR), vascular age (VA), and prevalence of peripheral arterial disease (PAD) in the multi-pathological population admitted to Internal Medicine services, as well as to study the relationship between PAD and Mönckeberg's calcifi cation with VA and cardiovascular risk factors (CRF) in this population. Material and method:Cross-sectional observational study, including multi-pathological patients admitted to Internal Medicine, excluding those with diagnosed PAD. Demographic variables, anklebrachial index (ABI), presence of multi-pathology, CRF present, CVR measured by SCORE and VA were recorded.Results: 414 patients were included: 54.8% were men and 45.2% were women. The most prevalent pathology was heart failure followed by chronic respiratory insuffi ciency, ischemic heart disease and chronic anaemia secondary to digestive bleeding. 25.3% of patients have PAD, which is signifi cantly associated with ischemic heart disease and type 2 diabetes mellitus with target organ injuries. 21.2% of the sample suffers from Mönckeberg calcifi cation and in 53.5 the ABI is normal. CVR and VA were calculated in patients younger than 65 years (22.16%), PAD was associated with SCORE> 5% and a high VA. Conclusion:This study highlights the importance of the determination of ABI, CVR and VA in patients admitted to Internal Medicine services. Since PAD is in the majority of cases asymptomatic and, therefore, underdiagnosed, its presence forces us to a comprehensive treatment of the patient to avoid any of these events.

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