The EKG in the patient treated with tricyclic antidepressants

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Associate Editor-In-Chief: Cafer Zorkun, M.D., Ph.D. [2]

Electrocardiographic Findings

1. EKG changes are observed in 20% of patients who are at therapeutic doses
2. Prolongation of the QTc, displacement of the ST segment, T wave abnormalities, QRS widening, supraventricular and ventricular tachycardias can all occur.
3. In overdose, widening of the QRS is frequent, and there is also QTc prolongation

Examples

Shown below is an image of EKG in a patient of nortriptyline intoxication demonstrating wide QRS complex and prolonged QT interval

Shown below is an image of EKG in a patient of nortriptyline intoxication demonstrating wide QRS and peaked T waves.

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Shown below are the EKG images of a patient with amitriptylin intoxication showing tachycardia with heart rate 130.

Before treatment

After treatment

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