All Supraventricular Tachycardia are not Cardiogenic: Case Report

Introduction: Tricyclic antideprressants have been commonly used for he treatment of depression, neuropathic pain, migren for a long time. The most toxic effects of tricyclic antideprressants are on cardiovascular system, otonomic nervous system and central nervous sytem. Case Report: Forty five years old female patient admitted to the emergency department with the complaints of altered mental status and agitation. Her glasgow coma scale was 11 (E2, M5, V4) and there was supraventricular tachycardia in her electrocardiography and corrected QT was 0.54 sec. Since there was nothing in the diagnosis of coma, poisoning thought and sodium bicarbonate treatment was begun and after treatment the rhythm was sinus tachycardia. After the history was detailed, it was learned that she was using amytriptillin 10 mg/ day because of major depression and administred plentous amount of this drug in order to suicide when her conscious was opened. On the third day of hospitalisation her vital signs were stable and she was discharged. Conclusion: Poisoning should be kept in mind in the differantial diagnosis of coma. Treatment of coma, electrocardiographic changes, hypotension, and seizures secondary to tricyclic antideprressants poisoning should be well known by emergency physicians and should not lost time for treatment.