What is an early sign of digitalis toxicity in a child with congestive heart failure?

Vomiting is a well-established early sign of digitalis toxicity, particularly in children. Digitalis, commonly used in treating congestive heart failure, can lead to an accumulation of the drug in the body, particularly if dosages are not carefully monitored. Children, due to their metabolic rates and body composition, can be more susceptible to these toxic effects.

When a child experiences digitalis toxicity, the initial symptoms may include gastrointestinal disturbances, with vomiting being prominent. This symptom arises because digitalis can irritate the gastrointestinal tract and also affects the central nervous system, which can trigger nausea and vomiting.

In this context, awareness of these early indicators is critical for healthcare providers. Timely detection of vomiting can prompt further evaluation and intervention to prevent more severe manifestations of toxicity, which can include arrhythmias and other serious complications.