The Role of Verapamil Toxicity in the Vicious Cycle of Bradycardia, Renal Failure, Atrioventricular Nodal Blockade, Shock, and Hyperkalemia (BRASH) Syndrome: A Case Report

BRASH is an acronym describing the vicious cycle seen in patients taking atrioventricular (AV) nodal blockers who tend to present with bradycardia, renal failure, atrioventricular nodal blockade, shock, and hyperkalemia. Herein, we report the case of an 87-year-old hypertensive patient on verapamil...

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Autores principales: Kazim, Yasmin H, Farzin, Farnoosh J, Kambal, Ivyan, Muhammed Nouri, Omar Q
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Cureus 2022
Materias:
Cardiology
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9733795/
https://www.ncbi.nlm.nih.gov/pubmed/36514700
http://dx.doi.org/10.7759/cureus.32336
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author Kazim, Yasmin H
Farzin, Farnoosh J
Kambal, Ivyan
Muhammed Nouri, Omar Q
author_facet Kazim, Yasmin H
Farzin, Farnoosh J
Kambal, Ivyan
Muhammed Nouri, Omar Q
author_sort Kazim, Yasmin H
collection PubMed
description BRASH is an acronym describing the vicious cycle seen in patients taking atrioventricular (AV) nodal blockers who tend to present with bradycardia, renal failure, atrioventricular nodal blockade, shock, and hyperkalemia. Herein, we report the case of an 87-year-old hypertensive patient on verapamil who presented with complaints of fever and shortness of breath. She was found to have bradycardia, hyperkalemia, renal impairment, and borderline hypotension. Differentiating this case from previous case reports on BRASH syndrome, this patient was found to simultaneously have toxic levels of serum verapamil.
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spelling pubmed-97337952022-12-12 The Role of Verapamil Toxicity in the Vicious Cycle of Bradycardia, Renal Failure, Atrioventricular Nodal Blockade, Shock, and Hyperkalemia (BRASH) Syndrome: A Case Report Kazim, Yasmin H Farzin, Farnoosh J Kambal, Ivyan Muhammed Nouri, Omar Q Cureus Cardiology BRASH is an acronym describing the vicious cycle seen in patients taking atrioventricular (AV) nodal blockers who tend to present with bradycardia, renal failure, atrioventricular nodal blockade, shock, and hyperkalemia. Herein, we report the case of an 87-year-old hypertensive patient on verapamil who presented with complaints of fever and shortness of breath. She was found to have bradycardia, hyperkalemia, renal impairment, and borderline hypotension. Differentiating this case from previous case reports on BRASH syndrome, this patient was found to simultaneously have toxic levels of serum verapamil. Cureus 2022-12-08 /pmc/articles/PMC9733795/ /pubmed/36514700 http://dx.doi.org/10.7759/cureus.32336 Text en Copyright © 2022, Kazim 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
Kazim, Yasmin H
Farzin, Farnoosh J
Kambal, Ivyan
Muhammed Nouri, Omar Q
The Role of Verapamil Toxicity in the Vicious Cycle of Bradycardia, Renal Failure, Atrioventricular Nodal Blockade, Shock, and Hyperkalemia (BRASH) Syndrome: A Case Report
title The Role of Verapamil Toxicity in the Vicious Cycle of Bradycardia, Renal Failure, Atrioventricular Nodal Blockade, Shock, and Hyperkalemia (BRASH) Syndrome: A Case Report
title_full The Role of Verapamil Toxicity in the Vicious Cycle of Bradycardia, Renal Failure, Atrioventricular Nodal Blockade, Shock, and Hyperkalemia (BRASH) Syndrome: A Case Report
title_fullStr The Role of Verapamil Toxicity in the Vicious Cycle of Bradycardia, Renal Failure, Atrioventricular Nodal Blockade, Shock, and Hyperkalemia (BRASH) Syndrome: A Case Report
title_full_unstemmed The Role of Verapamil Toxicity in the Vicious Cycle of Bradycardia, Renal Failure, Atrioventricular Nodal Blockade, Shock, and Hyperkalemia (BRASH) Syndrome: A Case Report
title_short The Role of Verapamil Toxicity in the Vicious Cycle of Bradycardia, Renal Failure, Atrioventricular Nodal Blockade, Shock, and Hyperkalemia (BRASH) Syndrome: A Case Report
title_sort role of verapamil toxicity in the vicious cycle of bradycardia, renal failure, atrioventricular nodal blockade, shock, and hyperkalemia (brash) syndrome: a case report
topic Cardiology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9733795/
https://www.ncbi.nlm.nih.gov/pubmed/36514700
http://dx.doi.org/10.7759/cureus.32336
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