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