Patel Kunj, Singh Varinder, Bissonette Andrew
Internal Medicine, Henry Ford Health System, Detroit, USA.
Cureus. 2023 Jun 9;15(6):e40176. doi: 10.7759/cureus.40176. eCollection 2023 Jun.
The BRASH syndrome is a recently recognized syndrome and the acronym stands for bradycardia, renal failure, atrioventricular (AV) blockade, shock, and hyperkalemia. We discuss a case of a 56-year-old female with a history of heart failure who presented in a critical state following recent adjustments to her carvedilol dosage while she was simultaneously on verapamil. This combination of AV nodal-blocking agents induced bradycardia in the patient, leading to shock and renal hypoperfusion complicated by hyperkalemia that required the use of a temporary transvenous pacemaker before she made a full recovery. The case report highlights the fact that this combination of medications alone may have had a synergistic effect that led to BRASH in our patient.
BRASH综合征是一种最近才被认识的综合征，其首字母缩写代表心动过缓、肾衰竭、房室传导阻滞、休克和高钾血症。我们讨论了一例56岁有心力衰竭病史的女性病例，她在最近调整卡维地洛剂量的同时还服用维拉帕米，随后病情危急。这种房室结阻滞剂的联合使用导致患者心动过缓，进而引发休克和肾灌注不足，并伴有高钾血症，在她完全康复之前需要使用临时静脉起搏器。该病例报告强调了这样一个事实，即仅这两种药物的联合使用可能产生了协同作用，导致我们的患者出现BRASH综合征。
