What is an expected finding on Madelyn's EKG in relation to tricyclic antidepressant ingestion?

In the context of tricyclic antidepressant (TCA) ingestion, an irregularly irregular rhythm accompanied by a prolonged QT interval is a significant finding that can be detected on an electrocardiogram (EKG). TCAs are known to affect cardiac conduction and can lead to several changes in the heart's rhythm and electrical activity.

Prolonged QT interval is particularly concerning because it can predispose individuals to life-threatening arrhythmias such as torsades de pointes. The irregular rhythm may be indicative of conduction disturbances that result from the anticholinergic effects of TCAs, which can alter heart rate and rhythm as well as lead to effects on ventricular conduction.

In contrast, a normal sinus rhythm would not typically be expected in TCA overdose due to the drug's notable impacts on cardiac function. Bradycardia with elevated heart rate is contradictory, as bradycardia refers to a slow heart rate, which doesn't align with the expected tachycardia or arrhythmia seen in toxicity cases. Lastly, a shortened PR interval is also not characteristic of TCA ingestion, as these agents commonly lead to longer PR intervals or other conduction disturbances rather than reductions. The effects of TCAs on the heart are complex, but the most consistent and