What are the common EKG findings in Tricyclic Antidepressant (TCA) overdose?

In the context of Tricyclic Antidepressant (TCA) overdose, the common EKG findings prominently include a widened QRS complex and prolonged QT interval. The widening of the QRS is significant because it reflects the impact of TCAs on cardiac conduction, particularly in the His-Purkinje system, which can be exacerbated by the sodium channel blockade that occurs during an overdose. This altered conduction can lead to serious arrhythmias, specifically ventricular tachycardia or even ventricular fibrillation in severe cases.

Prolonged QT interval is also a critical finding that suggests an increased risk for torsades de pointes, a potentially life-threatening arrhythmia. This elongation of the QT interval is due to the effect of TCAs on the repolarization phase of the cardiac cycle, resulting in delays that can have clinical consequences.

While other options may suggest potential findings associated with various cardiac conditions or drug effects, they do not align with the distinct and commonly recognized presentation of TCA overdose. Thus, recognizing the widened QRS and prolonged QT can guide paramedics and medical personnel in the management of a TCA overdose, as EMTs and healthcare providers take immediate actions to mitigate the risks associated with these EKG changes.