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Tricyclic antidepressant overdose — RCPSC EM MCQ

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EasyToxicologyTricyclic antidepressant overdoseRCPSC EM

A 36-year-old is brought in after a large amitriptyline overdose. He is hypotensive and drowsy. ECG shows QRS 150 ms and terminal R wave in aVR. What is the most likely diagnosis?

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Correct answer: A — Tricyclic antidepressant cardiotoxicity

Tricyclic antidepressant cardiotoxicity is correct: the clues indicate Tricyclic antidepressant overdose and this option addresses the immediate ED priority. The distractors delay care, target a less likely problem, or are unsafe in this physiology.

Reference: Goldfrank's Toxicologic Emergencies; Canadian poison centre practice