ST-T segment changes in patients with tricyclic antidepressant poisoning.

Gheshlaghi, Farzad. and Karbalayi Mehrizi, Mozhgan. and Yaraghi, Ahmad. and Sabzghabaee, Ali Mohammad. and Soltaninejad, Forough. and Eizadi-Mood, Nastaran. (2013) ST-T segment changes in patients with tricyclic antidepressant poisoning. Journal of research in pharmacy practice, 2 (3). pp. 110-3. ISSN 2319-9644

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Abstract

OBJECTIVE Tricyclic antidepressant (TCA) poisoning is among highly prevalent and potentially dangerous toxicities. ST-T changes are observed in the electrocardiogram (ECG) of most of TCA poisoned patients. We aimed to study ST-T segment changes in TCA toxicity and its probable relationship with other ECG findings. METHODS This retrospective study was carried out in Noor and Ali Asghar University Hospital, Isfahan (Iran) in 2012. Patients with TCA toxicity based on the patients' history who had not consumed any cardio-active drugs and did not have a past medical history of cardiovascular disease in the recent 5 years, were randomly selected and investigated. Their demographic and medical data on admission including ECG, age, sex, type and amount of ingested TCA, poisoning severity score, QRS changes, QT interval, heart axis position and R-wave were all recorded. ST-T changes and their relation with other ECG parameters have been determined using statistical analysis. FINDINGS Medical records of 272 patients were analyzed. In symptomatic patients, ST change prevalence was 40.8% and T change prevalence was 9.5%. In asymptomatic patients, the frequency of ST and T changes were 4.8% and 0.8%, respectively (P < 0.05). The most common ST and T changes in baseline (on admission) ECG were non-significant elevation (15.4%), significant elevation (11%) in pre-cordial leads, and T-wave flattening (6.6%). A statistically significant correlation was documented between ST segment changes with QRS and R-wave in aVR. The correlation between T-wave changes and R-wave in aVR lead was also significant. CONCLUSION ST-T changes in TCA poisoned patients are more prevalent in symptomatic patients. Obviously for a more definite conclusion, it is necessary to design a prospective study with the control group. This may facilitate a better understanding of ST-T segment changes.

Item Type: Article
Uncontrolled Keywords: Electrocardiogram; poisoning; toxicity; tricyclic antidepressant
Subjects: WM Psychiatry
QV pharmacology > QV 600 Toxicology
Divisions: Faculty of Medicine > Department of Clinical Sciences > Department of Internal Medicine
Depositing User: zahra bagheri .
Date Deposited: 13 Aug 2017 03:19
Last Modified: 24 Apr 2018 07:40
URI: http://eprints.skums.ac.ir/id/eprint/2761

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