title: Brugada electrocardiographic pattern induced by amitriptyline overdose.
abstract: 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.
authors.affiliation: Department of Medicine, New York Medical College, Valhalla, NY, USA. drpchandrasekar@gmail.com
authors.forename: Chandrasekar
authors.initials: C
authors.lastname: Palaniswamy
authors.forename: Dhana Rekha
authors.initials: DR
authors.lastname: Selvaraj
authors.forename: Tarun
authors.initials: T
authors.lastname: Chugh
authors.forename: Tarunjit
authors.initials: T
authors.lastname: Singh
authors.forename: Omar
authors.initials: O
authors.lastname: Khalique
authors.forename: Fausan
authors.initials: F
authors.lastname: Tsai
authors.forename: Rasham
authors.initials: R
authors.lastname: Sandhu
mesh_terms: 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
chemical_list: D000929:Antidepressive Agents, Tricyclic; D000639:Amitriptyline; D017693:Sodium Bicarbonate