ArticleWorld journal of clinical cases2025
Critical presentation of bradycardia, renal failure, atrioventricular nodal blockade, shock, and hyperkalemia syndrome: A case report.
Article in World journal of clinical cases, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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6 authors.
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Abstract
backgroundBradycardia, renal failure, atrioventricular nodal blockade, shock, and hyperkalemia (BRASH) syndrome is an acronym used to describe a constellation of BRASH. It is an underrecognized phenomenon that can be deadly if not appropriately managed in a timely manner. This case highlights the importance of rapid diagnosis and reviews a multitude of treatment options in a uniquely severe case of BRASH syndrome. CASE SUMMARY: We present a case of a 54-year-old male on a beta-blocker and angiotensin-converting enzyme inhibitor who presented with one day history of nausea, vomiting, and shortness of breath. Upon presentation, he was bradycardic and hypotensive, requiring transcutaneous pacing. Initial electrocardiogram showed atrial fibrillation with ventricular rate in 30's. He was found to have acute kidney injury, hyperkalemia, and metabolic acidosis. He was successfully treated with multiple potassium lowering agents, continuous renal replacement therapy, four pressors, mechanical ventilation, and transvenous pacing with complete recovery prior to discharge.
conclusionIncreased awareness of BRASH syndrome may improve outcomes through timely diagnosis and aggressive intervention.
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