World journal of clinical cases · 2025
Critical presentation of bradycardia, renal failure, atrioventricular nodal blockade, shock, and hyperkalemia syndrome: A case report.
Клинический случайСтатьяНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
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История · было → стало
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Pavlatos Nicholas Thales, Daga Pawan, Smiley Zyad, Belur Agastya, Bhattacharya Priyanka, Khan Rafay
Аннотация
BACKGROUND: Bradycardia, 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.
CONCLUSION: Increased awareness of BRASH syndrome may improve outcomes through timely diagnosis and aggressive intervention.
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.
CONCLUSION: Increased awareness of BRASH syndrome may improve outcomes through timely diagnosis and aggressive intervention.