Background Tricyclic antidepressants (TCA) are becoming one of the most frequently used substances in self poisoning. Significant morbidity and mortality associated with TCA overdose are often related to and refractory hypotension. We report the first case of survival after severe amitriptyline...
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"A 25 year old girl presented with severe amitriptyline poisoning causing pulseless VT and prolonged cardiac arrest. After 3 h of uninterrupted external cardiac massage, together with nine DC shocks and intra venous bicarbonate injections the rhythm reverted to a nodal tachycardia, initial 2D echocardiogram showed left ventricular dysfunction, which recovered to normal after 2 weeks and the patient had a complete recovery subsequently."
"She was extubated on fourth day and was transferred to the medical ward for continuation of care. She was discharged after 1 week from the incident, when she obtained complete recovery."
"Her follow up ECGs done at 1 week and 1 month after discharge, showed sinus rhythm with normal T waves. The repeat 2D echocardiogram performed after 2 weeks showed improvement in her ejection fraction to 55 % with normal sized cardiac chambers. She did not have any other neurological deficits except for the short term retrograde amnesia that persisted."