BRASH Syndrome: A Case Report and Literature Review

Abstract

BRASH syndrome is a newly coined diagnosis consisting of the clinical pentad of bradycardia, renal failure, atrioventricular (AV) nodal blockade, shock, and hyperkalemia. It is a rare syndrome with just under 50 reported cases. This case report and literature review present a case of BRASH syndrome, refractory to pharmaceutical measures, and subsequent literature review to assess treatment decisions and overall outcomes. The consensus from the literature supports the use of advanced interventions in most cases, including transcutaneous or transvenous pacing, hemodialysis, and adrenergic support. The early recognition and initiation of treatment in this patient demographic are paramount to reducing possible multi-system organ damage and mortality. This case report and literature review aim to improve patient outcomes and help further elucidate a protocol for treating BRASH syndrome.