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Case Reports
. 2020 Jul-Sep;16(3):241-244.
doi: 10.14797/mdcj-16-3-241.

BRASH Syndrome with Hyperkalemia: An Under-Recognized Clinical Condition

Abdul Wahab Arif  1 , Muhammad Shahzeb Khan  1 , Abdallah Masri  1 , Benjamin Mba  1 , Muhammad Talha Ayub  2 , Rami Doukky  1   2
Affiliations
Case Reports

BRASH Syndrome with Hyperkalemia: An Under-Recognized Clinical Condition

Abdul Wahab Arif et al. Methodist Debakey Cardiovasc J. 2020 Jul-Sep.

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.

Keywords: BRASH syndrome; atrioventricular nodal blocker; bradycardia; hyperkalemia; renal failure; shock.

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Conflict of interest statement

Conflict of Interest Disclosure: The authors have completed and submitted the Methodist DeBakey Cardiovascular Journal Conflict of Interest Statement and none were reported.

Figures

Figure 1.
Figure 1.
Sinus rhythm with nonspecific T wave abnormalities.
Figure 2.
Figure 2.
Narrow-complex bradycardia.
Figure 3.
Figure 3.
The vicious cycle of BRASH syndrome. AVNB: atrioventricular nodal blocker
See this image and copyright information in PMC

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