Although digoxin has played a major role in the therapy of congestive heart failure, its narrow therapeutic index, limited published data on efficacy in children, and the widespread availability of newer drugs like Angiotensin Converting Enzyme inhibitors, has made clinicians questioning the role of digoxin in the present day management of heart failure in children. In this article we have tried to focus on the literature available on the use of these two agents either alone or in combination with other agents and have tried to come up with practical recommendations that are specific to a particular physiologic state.

Key words: Cardiac failure; Cardiac glycosides; Digoxin; ACE inhibitor.