Cardiac Manifestations of Nutritional Deficiencies

Nutritional deficiencies remain an important yet underrecognized cause of cardiovascular morbidity worldwide. Our review examines how deficiencies in key micronutrients and macronutrients lead to distinct cardiac manifestations, ranging from structural alterations to functional impairments. We begin with water-soluble vitamins, highlighting classic manifestations like thiamin deficiency and wet beriberi, later pyridoxine, folate, cobalamin, and ascorbic acid. Next, we discuss fat-soluble vitamins A, D, E, and K. We also address the role of minerals, including calcium, iodine, magnesium, potassium, selenium, zinc, and iron, each of which contributes to myocardial function, vascular regulation, or arrhythmogenic risk. Finally, we discuss macronutrients like proteins, fatty acids, and carbohydrates, and their broader influence on myocardial integrity and energy metabolism. Recognition of these nutritional contributors is essential for timely diagnosis and intervention, as many cardiac effects are reversible with supplementation. Importantly, a comprehensive approach must also account for social determinants of health, since nutritional deficiencies disproportionately affect vulnerable populations, particularly those with lower socioeconomic status. This review highlights the diverse spectrum of cardiac manifestations associated with nutritional deficiencies and underscores the importance of integrating nutritional assessment into cardiovascular care.