A Combination of Beta-Blockade and Calcium Channel Blockade Leading to Bradycardia, Renal Failure, Atrioventricular Blockade, Shock, and Hyperkalemia (BRASH) Syndrome: A Case Report

The BRASH syndrome is a recently recognized syndrome and the acronym stands for bradycardia, renal failure, atrioventricular (AV) blockade, shock, and hyperkalemia. We discuss a case of a 56-year-old female with a history of heart failure who presented in a critical state following recent adjustment...

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Detalles Bibliográficos
Autores principales: Patel, Kunj, Singh, Varinder, Bissonette, Andrew
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Cureus 2023
Materias:
Cardiology
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10277163/
https://www.ncbi.nlm.nih.gov/pubmed/37337555
http://dx.doi.org/10.7759/cureus.40176
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author Patel, Kunj
Singh, Varinder
Bissonette, Andrew
author_facet Patel, Kunj
Singh, Varinder
Bissonette, Andrew
author_sort Patel, Kunj
collection PubMed
description The BRASH syndrome is a recently recognized syndrome and the acronym stands for bradycardia, renal failure, atrioventricular (AV) blockade, shock, and hyperkalemia. We discuss a case of a 56-year-old female with a history of heart failure who presented in a critical state following recent adjustments to her carvedilol dosage while she was simultaneously on verapamil. This combination of AV nodal-blocking agents induced bradycardia in the patient, leading to shock and renal hypoperfusion complicated by hyperkalemia that required the use of a temporary transvenous pacemaker before she made a full recovery. The case report highlights the fact that this combination of medications alone may have had a synergistic effect that led to BRASH in our patient.
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spelling pubmed-102771632023-06-19 A Combination of Beta-Blockade and Calcium Channel Blockade Leading to Bradycardia, Renal Failure, Atrioventricular Blockade, Shock, and Hyperkalemia (BRASH) Syndrome: A Case Report Patel, Kunj Singh, Varinder Bissonette, Andrew Cureus Cardiology The BRASH syndrome is a recently recognized syndrome and the acronym stands for bradycardia, renal failure, atrioventricular (AV) blockade, shock, and hyperkalemia. We discuss a case of a 56-year-old female with a history of heart failure who presented in a critical state following recent adjustments to her carvedilol dosage while she was simultaneously on verapamil. This combination of AV nodal-blocking agents induced bradycardia in the patient, leading to shock and renal hypoperfusion complicated by hyperkalemia that required the use of a temporary transvenous pacemaker before she made a full recovery. The case report highlights the fact that this combination of medications alone may have had a synergistic effect that led to BRASH in our patient. Cureus 2023-06-09 /pmc/articles/PMC10277163/ /pubmed/37337555 http://dx.doi.org/10.7759/cureus.40176 Text en Copyright © 2023, Patel et al. https://creativecommons.org/licenses/by/3.0/This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Cardiology
Patel, Kunj
Singh, Varinder
Bissonette, Andrew
A Combination of Beta-Blockade and Calcium Channel Blockade Leading to Bradycardia, Renal Failure, Atrioventricular Blockade, Shock, and Hyperkalemia (BRASH) Syndrome: A Case Report
title A Combination of Beta-Blockade and Calcium Channel Blockade Leading to Bradycardia, Renal Failure, Atrioventricular Blockade, Shock, and Hyperkalemia (BRASH) Syndrome: A Case Report
title_full A Combination of Beta-Blockade and Calcium Channel Blockade Leading to Bradycardia, Renal Failure, Atrioventricular Blockade, Shock, and Hyperkalemia (BRASH) Syndrome: A Case Report
title_fullStr A Combination of Beta-Blockade and Calcium Channel Blockade Leading to Bradycardia, Renal Failure, Atrioventricular Blockade, Shock, and Hyperkalemia (BRASH) Syndrome: A Case Report
title_full_unstemmed A Combination of Beta-Blockade and Calcium Channel Blockade Leading to Bradycardia, Renal Failure, Atrioventricular Blockade, Shock, and Hyperkalemia (BRASH) Syndrome: A Case Report
title_short A Combination of Beta-Blockade and Calcium Channel Blockade Leading to Bradycardia, Renal Failure, Atrioventricular Blockade, Shock, and Hyperkalemia (BRASH) Syndrome: A Case Report
title_sort combination of beta-blockade and calcium channel blockade leading to bradycardia, renal failure, atrioventricular blockade, shock, and hyperkalemia (brash) syndrome: a case report
topic Cardiology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10277163/
https://www.ncbi.nlm.nih.gov/pubmed/37337555
http://dx.doi.org/10.7759/cureus.40176
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