ST Elevation in Tricyclic Antidepressants Toxicity: A Case Report

Of all antidepressants, tricyclic antidepressants (TCAs) are the most toxic drugs and they are often used for suicide attempts. An 18-year-old female was admitted to the emergency department after having taken 30 tablets of Nortriptyline 50 mg in a suicide attempt. A twelve-lead electrocardiogram revealed right bundle branch block in leads V1, V2, and V3 as well as deep S in leads İ, V5, and V6, and tall R in AVR, which meant extreme right axis and ST elevation in leads V2 and V3: that raised the suspicion of the Brugada syndrome. ST elevation after TCA toxicity is a rare medical condition, and our literature review failed to find any relevant reports.