Critical presentation of bradycardia, renal failure, atrioventricular nodal blockade, shock, and hyperkalemia syndrome: A case report

doi:10.12998/wjcc.v13.i25.107948

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Sep 6, 2025 (publication date) through Jul 7, 2025

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World Journal of Clinical Cases

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2307-8960

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Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA

Case Report

World J Clin Cases. Sep 6, 2025; 13(25): 107948
Published online Sep 6, 2025. doi: 10.12998/wjcc.v13.i25.107948

Critical presentation of bradycardia, renal failure, atrioventricular nodal blockade, shock, and hyperkalemia syndrome: A case report

Nicholas Thales Pavlatos, Pawan Daga, Zyad Smiley, Agastya Belur, Priyanka Bhattacharya, Rafay Khan

Nicholas Thales Pavlatos, Pawan Daga, Zyad Smiley, Department of Internal Medicine, University of Louisville, Louisville, KY 40204, United States

Agastya Belur, Priyanka Bhattacharya, Rafay Khan, Department of Cardiovascular Medicine, University of Louisville, Louisville, KY 40204, United States

Author contributions: Pavlatos NT, Smiley Z, Bhattacharya P draft preparation and figure preparation; Daga P, Belur A, Khan K draft manuscript preparation and figure preparation. All authors have read and agreed to the published version of the manuscript.

Informed consent statement: All study participants, or their legal guardian, provided informed written consent prior to study enrollment.

Conflict-of-interest statement: We have no conflicts of interest to disclose. All authors declare that they have no conflicts of interest.

CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).

Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/

Corresponding author: Nicholas Thales Pavlatos, MD, Internal Medicine, University of Louisville, 550 South Jackson Street 3rd Floor, Ste. A3K00, Louisville, KY 40204, United States. ntpavl01@louisville.edu

Received: April 1, 2025
Revised: April 22, 2025
Accepted: May 18, 2025
Published online: September 6, 2025
Processing time: 97 Days and 9.4 Hours

Core Tip

Core Tip: Bradycardia, renal failure, atrioventricular nodal blockade, shock, and hyperkalemia (BRASH) syndrome is an acronym used to describe a constellation of BRASH. Effective management of BRASH syndrome often requires a multidisciplinary approach within the intensive care unit and consists of cessation of offending agents, potassium lowering measures, renal replacement therapy, hemodynamic pressor support, and/or cardiac pacing.