Brugada electrocardiographic pattern induced by amitriptyline overdose.
Tricyclic antidepressants (TCAs) remain a common cause of fatal drug poisoning as a result of their cardiovascular toxicity manifested by electrocardiographic abnormalities, arrhythmias, and hypotension. The principal mechanism of toxicity is cardiac sodium channel blockade. Brugada electrocardiographic pattern (BEP) has also been described in TCA overdose. Currently, very little is known about the relationship between the Brugada syndrome and TCAs. We report the case of a patient who presented with BEP after intake of a high dose of amitriptyline. The patient was treated with continuous sodium bicarbonate infusion leading to resolution of BEP.
Palaniswamy
Chandrasekar
C
Department of Medicine, New York Medical College, Valhalla, NY, USA. drpchandrasekar@gmail.com
Selvaraj
Dhana Rekha
DR
Chugh
Tarun
T
Singh
Tarunjit
T
Khalique
Omar
O
Tsai
Fausan
F
Sandhu
Rasham
R
D000639:Amitriptyline / Q000009:adverse effects / Q000506:poisoning*; D000929:Antidepressive Agents, Tricyclic / Q000009:adverse effects / Q000506:poisoning*; D001145:Arrhythmias, Cardiac / Q000188:drug therapy; D053840:Brugada Syndrome / Q000139:chemically induced*; D062787:Drug Overdose / Q000188:drug therapy; D004562:Electrocardiography; D006801:Humans; D008297:Male; D008875:Middle Aged; D017693:Sodium Bicarbonate / Q000037:antagonists & inhibitors
D000929:Antidepressive Agents, Tricyclic; D000639:Amitriptyline; D017693:Sodium Bicarbonate