04-10-2007, 08:26 PM
A 40-year-old woman is brought to the emergency department following a suicide attempt with imipramine. Her fiancee found her unresponsive, with an empty bottle of the imipramine at her side. The imipramine had been his, and the prescription had been filled that morning. Her past medical history is significant for hypertension, atrial fibrillation, diabetes, and asthma. Her medications include furosemide, procainamide, glyburide, prednisone, and albuterol. She has no known drug allergies. She is afebrile, has a blood pressure of 100/60 mm Hg, pulse of 62/min, and respirations of 22/min. A gastric lavage yields multiple pill fragments. She is confused and somnolent, and has shallow respirations. Her physical examination is otherwise unremarkable. On an ECG, which of the following abnormalities would most likely reflect possible cardiac toxicity?
A. Left deviation of the QRS axis
B. Prolongation of the QRS interval
C. Shortening of the QT interval
D. ST segment depression
E. T wave inversion
A. Left deviation of the QRS axis
B. Prolongation of the QRS interval
C. Shortening of the QT interval
D. ST segment depression
E. T wave inversion