BRASH syndrome: A case report
Abstract
BRASH syndrome results as a consequence of a chain of pathophysiological events that generally occurs in elderly patients, with underlying cardiac disease, treated with beta-blockers or calcium channel blockers, and who present hyperkalemia. This combination of events potentiates the adverse effects of these drugs, thus, bradycardia, hypoperfusion and shock may develop. We present the case of a 78-year-old male patient with a history of high blood pressure, diabetes mellitus and stage II chronic kidney disease, who was being treated with carvedilol and who attended the emergency department presenting the clinical features that characterize the syndrome. Despite the implantation of a temporary transvenous pacemaker, he died a few hours later. In this report is highlighted the importance of recognizing the factors that lead to the appearance of this syndrome, and the multimodal treatment that these patients need as part of the therapeutic protocol.
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