BRASH syndrome: A rare but reversible cause of sinus node dysfunction

BRASH syndrome is defined as a constellation of symptoms including bradycardia, renal failure, Atrioventricular (AV) nodal blocker, shock, and hyperkalemia [1]. It is known to be caused by the synergistic effects of AV nodal blockers and renal dysfunction escalating the effect of the AV nodal blockade. Patients presenting with this syndrome can develop a wide range of clinical symptoms from asymptomatic bradycardia to cardiogenic shock. Unfortunately, it has become an underdiagnosed reversible cause of symptomatic bradycardia which has led to premature pacemaker implantation.