Thank you Dr. Daniel Jimenez for an excellent presentation on TCA induced cardiotoxicity

Teaching Points

  • Clinical presentation: anticholinergic sx (urinary retention, constipation), CNS (seizures, coma), acidosis, arrythmias
  • ECG: prolonged QRS/PR/QT –> predisposes for ventricular arrhythmias)
  • Management: supportive care, benzos for seizures, activated charcoal if 2 hours of ingestion, sodium bicarb if QRS>100msec (goal ph 7.5-7.55), aggressive IVF/pressor support if hypotensive

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