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Case Reports
. 2024 Aug 29;16(8):e68106.
doi: 10.7759/cureus.68106. eCollection 2024 Aug.

BRASH (Bradycardia, Renal Failure, Atrioventricular Nodal Blockade, Shock, and Hyperkalemia) Syndrome: A Frequently Underrecognized Condition Often Confused With Simple Hyperkalemia

Karandeep Singh  1 , Kunal N Patel  2
Affiliations
Case Reports

BRASH (Bradycardia, Renal Failure, Atrioventricular Nodal Blockade, Shock, and Hyperkalemia) Syndrome: A Frequently Underrecognized Condition Often Confused With Simple Hyperkalemia

Karandeep Singh et al. Cureus. .

Abstract

BRASH syndrome, defined by bradycardia, renal failure, atrioventricular nodal blockade, shock, and hyperkalemia, is a relatively new and often underrecognized condition. In this article, we present a case of an elderly female who developed an episode of syncope. She was found to have refractory shock and bradycardia in the emergency department. Laboratory results and other findings led to the diagnosis of a BRASH syndrome, which was refractory to medical therapy alone, requiring transvenous pacing, hemodialysis, and vasopressor support.

Keywords: acute renal failure and hemodialysis in icu; av nodal blockers; bradycardia; brash syndrome; cardiology; hyperkalemia.

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Conflict of interest statement

Human subjects: Consent was obtained or waived by all participants in this study. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work.

Figures

Figure 1
Figure 1. Admission EKG showing atrial fibrillation with a ventricular rate of 31 bpm and peaked T-waves
EKG: Electrocardiogram.
See this image and copyright information in PMC

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