BRASH syndrome: a literature review
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Abstract
BRASH syndrome is a clinical condition resulting from the synergistic interaction between atrioventricular nodal-blocking agents and
hyperkalemia, creating a potentially life-threatening vicious cycle. Despite increasing recognition in recent literature since its first
description in 2016, BRASH syndrome remains underrecognized by many healthcare professionals. Timely identification is crucial to
ensure appropriate management, avoiding unnecessary invasive interventions and ineffective treatments. This is particularly relevant
because the American Heart Association algorithm – commonly employed for managing bradyarrhythmias – does not currently
address isolated hyperkalemia or BRASH syndrome specifically. Furthermore, given its strong association with advanced age and
polypharmacy, BRASH syndrome is expected to become increasingly prevalent in acute and critical care settings, such as emergency
departments and intensive care units, as the population ages. The aim of this article is to objectively raise awareness about BRASH
syndrome, supporting healthcare professionals in its prompt recognition, effective management, and targeted treatment.
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References
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