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BRASH syndrome: A rare, vicious cycle

Kaegan G Williams1, Rachel S Robeck

  • 1At Brooke Army Medical Center in Fort Sam Houston, Tex., Kaegan G. Williams is an advanced emergency medicine ultrasound PA fellow and Rachel S. Robeck is research director of the US Army-Baylor University Emergency Medicine PA Fellowship. Dr. Robeck also practices at the Naval Medical Research Unit in San Antonio, Tex. The views expressed herein are those of the authors and do not necessarily reflect the official policy or position of the Defense Health Agency, Brooke Army Medical Center, or the Department of Defense, nor any agencies under the US government. The authors have disclosed no potential conflicts of interest, financial or otherwise.

JAAPA : Official Journal of the American Academy of Physician Assistants
|August 7, 2026
PubMed
Summary

BRASH syndrome, a dangerous cycle of bradycardia, renal failure, atrioventricular nodal blockade, shock, and hyperkalemia, can resist standard treatments. Prompt recognition and intervention are crucial to avert severe patient decline and multiorgan failure.

Keywords:
BRASHatrioventricular node blockadebradycardiahyperkalemiahypotensionrenal failure

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