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[Beriberi heart disease]
1Hospital Auxiliar de Cotoxó, Instituto do Coração do Hospital das Clínicas, FMUSP, São Paulo.
Arquivos Brasileiros De Cardiologia
|March 1, 1991
Insights
Chronic alcoholism can cause congestive heart failure with high cardiac output. Alcohol withdrawal, rest, and nutrition resolved symptoms and heart enlargement without thiamine supplementation.
Area of Science:
- Cardiology
- Internal Medicine
- Toxicology
Background:
- Chronic alcoholism is a significant risk factor for cardiovascular disease.
- Alcohol-induced cardiomyopathy can manifest with heart failure symptoms.
- Hyperdynamic circulation is sometimes observed in advanced alcoholic heart disease.
Observation:
- A patient with chronic alcoholism presented with new-onset congestive heart failure.
- Clinical signs indicated a hyperdynamic state with a low arteriovenous oxygen content difference, suggesting high cardiac output.
- Cardiomegaly was evident on initial examination.
Findings:
- The patient's congestive heart failure and hyperdynamic features resolved within 10 days of alcohol withdrawal.
- Rest and balanced nutritional support were key components of the treatment.
- No thiamine supplementation was needed for recovery.
Implications:
- This case highlights the potential reversibility of alcohol-induced heart failure with prompt cessation of alcohol consumption.
- It suggests that not all cases of alcoholic cardiomyopathy require thiamine, challenging some traditional treatment paradigms.
- Early intervention focusing on alcohol abstinence and supportive care can lead to significant clinical improvement and resolution of cardiomegaly.
Abstract:
A man with chronic alcoholism presenting with recent-onset congestive heart failure and hyperdynamic features. Low arteriovenous oxygen content difference suggested high cardiac output. After 10 days of alcohol withdrawal, rest and balanced feeding the patient was asymptomatic and cardiomegaly subsided. No supplementation of thiamine was required.