BRASH Syndrome with Hyperkalemia: An Under-Recognized Clinical Condition
Abdul Wahab Arif, Muhammad Shahzeb Khan, Abdallah Masri, Benjamín Mba, Muhammad Talha Ayub, Rami Doukky
Abstract
BRASH syndrome is characterized by bradycardia, renal failure, use of an atrioventricular nodal blocker (AVNB), shock, and hyperkalemia. These symptoms represent an ongoing vicious cycle in a patient with a low glomerular filtration rate taking an AVNB. Decreased clearance of the medication and hyperkalemia associated with renal failure synergize to cause bradycardia and hypoperfusion. This reaction causes renal function to worsen, thereby perpetuating the cycle of BRASH syndrome.
Topics & Concepts
MedicineHyperkalemiaBradycardiaRenal functionCardiologyShock (circulatory)Internal medicineIntensive care medicineHeart rateBlood pressurePotassium and Related DisordersCardiac electrophysiology and arrhythmiasIon channel regulation and function