BRASH Syndrome: A Rare Clinical Phenomenon

Bradycardia, Renal Failure, Atrioventricular Nodal Blockade, Shock, and Hyperkalemia (BRASH) Syndrome is a rare medical phenomenon with approximately only 70 reported cases carrying a mortality of 5.7%. [1,2] Presentation is variable but can range from asymptomatic bradycardia to multisystem organ failure. [3] The unique pathophysiology of BRASH syndrome involves synergy between Atrioventricular (AV) Nodal blocking agents and hyperkalemia leading to severe bradycardia and renal malperfusion. Here we present a case of a 66-year-old female who was found to fit the clinical picture of BRASH Syndrome in which the prompt diagnosis and intervention led to a positive outcome.