Volume 25, Issue 113, July 2021

Bradycardia, Renal failure, AV node blocker, Shock, Hyperkalemia (BRASH syndrome): Don’t ignore it

Prerna Verma¹, Dhruv Talwar^1♦, Neha Phate¹, Sunil Kumar²

¹Post Graduate Resident, Department of Medicine, Jawaharlal Nehru Medical College, Datta Meghe Institute of Medical Sciences (Deemed to be University), Wardha, Maharastra, India
²Professor, Department of Medicine, Jawaharlal Nehru Medical College, Datta Meghe Institute of Medical Sciences (Deemed to be University), Wardha, Maharastra, India

^♦Corresponding author
Post Graduate Resident, Department of Medicine, Jawaharlal Nehru Medical College, Datta Meghe Institute of Medical Sciences (Deemed to be University), Wardha, Maharastra, India

ABSTRACT

BRASH syndrome is characterised by bradycardia, renal failure, hyperkalemia and use of an AV nodal blocker (AVNB). These symptoms form a vicious cycle seen in a patient having reduced glomerular filtration rate who are on AVNB. There is reduced excretion of AVNB in a patient with low glomerular filtration rate along with hyperkalemia due to renal failure. All of these factors precipitate the cycle of BRASH Syndrome. Here we present a case of 50 year old male presenting with bradycardia, renal failure and hyperkalemia and on history evaluation revealed to be on calcium channel blockers for hypertension precipitating BRASH Syndrome.

Keywords: BRASH, Bradycardia, CKD, hyperkalemia, hypertension

Medical Science, 2021, 25(113), 1513-1516

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