VOLUME 4 , ISSUE 2 ( March-April, 2025 ) > List of Articles
Ravi Ranjan, Nikesh K Roshan, Priya, Sneha Verma
Keywords : Atrioventricular block, BRASH syndrome, Case report, Hyperkalemia, Renal injury
Citation Information : Ranjan R, Roshan NK, Priya, Verma S. Bradycardia, Renal Failure, Atrioventricular Node Blockers, Shock, and Hyperkalemia Syndrome: A Tale of Hyperkalemia Bradyarrhythmia and Block. 2025; 4 (2):47-49.
DOI: 10.5005/jp-journals-11006-0157
License: CC BY-NC 4.0
Published Online: 25-02-2025
Copyright Statement: Copyright © 2025; The Author(s).
Aim and background: Bradycardia, renal failure, atrioventricular node blockers, shock, and hyperkalemia (BRASH) syndrome, a pentad of bradycardia, renal failure, atrioventricular (AV) block, shock, and hyperkalemia, was first coined in 2016 by Dr Josh Farkas. It represents a complex interplay between AV nodal block and hyperkalemia, leading to severe bradycardia and shock, often affecting older patients with limited renal reserve. However, it is still underrecognized, as even though there is a history of AV nodal blocker intake, it is not given the same importance as hyperkalemia due to its less ”fear factor.” Case description: We present the management of one such case: a 70-year-old female on amlodipine and atenolol. Her initial potassium level was 5.8 mEq/L and she was in a state of cardiogenic shock. Conclusion: With early intervention, the bradyarrhythmia in BRASH syndrome is reversible. The aim of this case report is to raise awareness of BRASH syndrome, as timely intervention will improve patient outcomes, and the offending agent can be withdrawn.
© Jaypee Brothers Medical Publishers (P) LTD.
