[Cardiovascular side effects of tricyclic psychopharmaca under special consideration of the ECG (author's transl)].

The cardialvascular side effects of tricyclic psychopharmaca.- alteration of blood pressure and heart rate in connection with hemodynamic effects, the "antiarrhythmic activity" and the abnormal ECG-findings - are reviewed. The ECG-changes are discussed in detail. They can be divided in disturbances of rhythm, conduction and repolarisation. After a survey over the usual interpretation of the ECG-findings a hypothesis for better understanding is presented. There is supposed - in close relation to the dosage - a direct affection of the myocardium (by enzyme suppression, disturbance of the membrane permeability?) connected with reflectory vegetative mechanisms which can be modified by factors like kind and severity of the illness, diurnal changes and many external influences, difficult to quantify and objectivate. So the transitory and alternating ECG-findings could be interpretated as a state-depending summation, subtraction or potentiation of the cited single effects.