Diagnosis of cardiac glycoside toxicity is typically based on clinical presentation, history of exposure, and laboratory tests. An electrocardiogram (ECG) may show characteristic changes, such as scooped ST segments or T-wave changes. Serum levels of specific cardiac glycosides, such as digoxin, can be measured to confirm toxicity. However, clinical correlation is crucial, as serum levels may not always correlate directly with toxicity due to individual variability in sensitivity.