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Bradycardia, Renal Failure, Atrioventricular (AV) Nodal Blockers, Shock, and Hyperkalemia (BRASH) Syndrome: A Confounder in the Clinical Practice.
Cureus
October 2024
Internal Medicine, Unidade Local de Saúde de Trás-os-Montes e Alto Douro, Chaves, PRT.
BRASH, an acronym for Bradycardia, Renal failure, AV nodal blockers, Shock, and Hyperkalemia, syndrome is a clinical synergic phenomenon that can result in cardiovascular collapse. We present the case of an 83-year-old woman with dilated cardiomyopathy, heart failure, and chronic kidney disease who was admitted to the emergency room due to syncope and a worsening general condition. The patient was on several medications, including carvedilol, a beta-blocker.
View Article and Find Full Text PDFIntensive Home Blood Pressure Lowering in Patients With Advanced CKD.
Am J Kidney Dis
October 2024
Division of Nephrology, Department of Medicine, University of California-San Francisco, San Francisco, California.
Article Synopsis
- The study investigates whether intensive blood pressure (BP) control can be safely achieved for patients with advanced chronic kidney disease (CKD) using remote monitoring and medication adjustment.
- In a pilot randomized trial involving 108 patients with advanced CKD and hypertension, participants were assigned to either a lower target systolic BP (<120 mmHg) or a less intensive target.
- Results showed that the intensive BP group achieved a significantly lower mean clinic systolic BP without a notable increase in safety risks, though the small sample size raises questions about the robustness of the findings.
BRASH syndrome, defined by bradycardia, renal failure, atrioventricular nodal blockade, shock, and hyperkalemia, is a relatively new and often underrecognized condition. In this article, we present a case of an elderly female who developed an episode of syncope. She was found to have refractory shock and bradycardia in the emergency department.
View Article and Find Full Text PDFSuspension syndrome: a scoping review and recommendations from the International Commission for Mountain Emergency Medicine (ICAR MEDCOM).
Scand J Trauma Resusc Emerg Med
December 2023
International Commission for Mountain Emergency Medicine (ICAR MedCom), Zurich, Switzerland.
Article Synopsis
- Suspension syndrome occurs when a person experiences cardio-circulatory collapse while hanging vertically, with ongoing debate about its causes.
- A scoping review by ICAR MedCom analyzed various studies to clarify the syndrome's pathophysiology and provide updated recommendations for its management.
- The findings suggest that suspension syndrome can lead to serious complications, including bradycardia and loss of consciousness, and emphasize the importance of prevention strategies and quick medical intervention in case of an emergency.
Beyond Syncopal Episodes: A Complicated Hyperkalemic Emergency Manifesting As Complete Heart Block and Seizure Versus Convulsive Syncope Cascade.
Cureus
July 2023
Internal Medicine, Wyckoff Heights Medical Center, Brooklyn, USA.
We present a case involving an 87-year-old woman who had a hyperkalemic emergency. This condition was further complicated by complete heart block (CHB) and seizure-like activity. This case emphasizes the challenge of differentiating between seizures and convulsive syncope.
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