A Case Report on Uremic Toxins and Their Effects on Cardiac Rhythm: Understanding Junctional Ventricular Escape Rhythm in Renal Failure.

brash syndrome cardiogenic shock junctional bradycardia uremia ventricular escape rhythm

Journal

Cureus
ISSN: 2168-8184
Titre abrégé: Cureus
Pays: United States
ID NLM: 101596737

Informations de publication

Date de publication:
Aug 2023
Historique:
accepted: 26 07 2023
medline: 11 9 2023
pubmed: 11 9 2023
entrez: 11 9 2023
Statut: epublish

Résumé

Understanding the reasons behind junctional ventricular escape rhythm is crucial for guiding the clinical management of patients. Various factors such as acidosis, hyperkalemia, metabolic toxins, digoxin toxicity, and BRASH syndrome (comprising bradycardia, renal failure, atrioventricular (AV) nodal blockade, shock, and hyperkalemia) should be considered when dealing with a symptomatic unstable patient in a hospital. In this case, we present an example where metabolic toxins, specifically uremia, in combination with other factors, lead the patient to enter a ventricular escape rhythm, ultimately resulting in cardiogenic shock. The main objective of this case study is to illustrate how uremic metabolic acidosis contributes to AV nodal blockade, leading to a junctional ventricular escape rhythm within the context of BRASH.

Identifiants

pubmed: 37692585
doi: 10.7759/cureus.43302
pmc: PMC10492656
doi:

Types de publication

Case Reports

Langues

eng

Pagination

e43302

Informations de copyright

Copyright © 2023, Sharma et al.

Déclaration de conflit d'intérêts

The authors have declared that no competing interests exist.

Références

Front Physiol. 2014 Jun 25;5:233
pubmed: 25009505
Circ Arrhythm Electrophysiol. 2017 Mar;10(3):
pubmed: 28314851
Cureus. 2019 Dec 21;11(12):e6439
pubmed: 31998568
Curr Probl Cardiol. 2023 Jun;48(6):101663
pubmed: 36842470

Auteurs

Manjari Sharma (M)

Internal Medicine, Wyckoff Heights Medical Center, Brooklyn, USA.

Mukosolu F Obi (MF)

Internal Medicine, Wyckoff Heights Medical Center, Brooklyn, USA.

Yash Garg (Y)

Internal Medicine, Wyckoff Heights Medical Center, Brooklyn, USA.

Karthik Seetharam (K)

Cardiology, Mount Sinai Hospital, New York, USA.

Hyun Joon Cho (HJ)

Internal Medicine, Wyckoff Heights Medical Center, Brooklyn, USA.

Classifications MeSH