Gouveia Rita, Veiga Hugo, Costa Ana A, Pereira Joana, Lourenço Patrícia
Department of Internal Medicine, Centro Hospitalar Universitário de São João, Porto, PRT.
Cureus. 2022 Jan 12;14(1):e21144. doi: 10.7759/cureus.21144. eCollection 2022 Jan.
We report the case of an 89-year-old female patient who presented to the emergency department with BRASH syndrome, an acronym that stands for bradycardia, renal failure, atrioventricular nodal blockade, shock, and hyperkalemia, which is an underdiagnosed and recently described clinical entity. Contrary to either hyperkalemia or atrioventricular nodal blockade alone, this syndrome represents the synergistic combination of both together, creating a vicious cycle. Conservative treatment of each component, avoiding invasive measures like dialysis or pacing, usually leads to complete resolution. Recognizing the existence of this syndrome is important for an integrative approach and to avoid its recurrence. The association between BRASH syndrome and amlodipine, a dihydropyridine calcium channel blocker, is not commonly described in literature.
我们报告了一例89岁女性患者，该患者因BRASH综合征就诊于急诊科。BRASH是心动过缓、肾衰竭、房室结阻滞、休克和高钾血症的首字母缩写词，这是一种诊断不足且最近才被描述的临床病症。与单独的高钾血症或房室结阻滞不同，该综合征代表两者的协同组合，形成恶性循环。对每个组成部分进行保守治疗，避免采取透析或起搏等侵入性措施，通常会导致完全缓解。认识到该综合征的存在对于采取综合治疗方法和避免其复发很重要。BRASH综合征与二氢吡啶类钙通道阻滞剂氨氯地平之间的关联在文献中并不常见。
