Seng Yung Liew and Yoon Chin Yap and Zhen Zhen Lo (2025) Brash syndrome – a rare cause of bradycardia with renal failure. Journal of Health and Translational Medicine (JUMMEC), 28 (1). pp. 1-6. ISSN 1823-7339
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Abstract
The BRASH syndrome is a rare clinical pentad characterised by bradycardia, renal failure, atrioventricular (AV) blockade, shock and hyperkalaemia. Patients with BRASH syndrome typically present with bradycardia and hypotension due to the synergistic effect of AV node blocker and hyperkalaemia, compounded by underlying renal failure. In this report, we present a young patient with a history of chronic kidney disease and hypertension, who was taking regular beta-blockers and calcium channel blockers, and presented with persistent dizziness, headache and lethargy, which progressed into bradycardia and shock. These symptoms were refractory to initial resuscitation, requiring inotropic support and urgent haemodialysis. The patient was discharged in good condition after initiating regular dialysis. A high index of suspicion and early recognition are key to managing BRASH syndrome. Standard advanced cardiac life support algorithms without calcium are generally impractical for BRASH syndrome. The prognosis for BRASH syndrome is excellent with timely recognition and management.
| Item Type: | Article |
|---|---|
| Keyword: | Bradycardia, Renal Failure, Hyperkalaemia |
| Subjects: | Q Science > QP Physiology > QP1-(981) Physiology > QP1-345 General Including influence of the environment R Medicine > RC Internal medicine > RC31-1245 Internal medicine > RC581-951 Specialties of internal medicine > RC870-923 Diseases of the genitourinary system. Urology |
| Department: | FACULTY > Faculty of Medicine and Health Sciences |
| Depositing User: | ABDULLAH BIN SABUDIN - |
| Date Deposited: | 15 Apr 2025 16:07 |
| Last Modified: | 15 Apr 2025 16:07 |
| URI: | https://eprints.ums.edu.my/id/eprint/43501 |
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