Brugada Pattern ECG: An Unusual Case of TCA TOXICITY

A 32 year old man after some untoward incidents at home came with history of abdominal pain, nausea and vomiting sine 3 hours. Initial evaluation revealed mild tachycardia and normal BP. He was started on symptomatic management and an ECG was taken which showed an incomplete RBBB pattern. On revaluation he was becoming drowsy and the monitors showed widening QRS. Repeat ECG showed a brugada pattern with typical changes and he was promptly treated with sodium bicarbonate as there was history of consumption of TCA tablets namely amitryptilline. His ECG reverted to the RBBB pattern and the patient got symptomatically better and was admitted for further evaluation