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[Shoshin beriberi. A rapidly curable hemodynamic disaster]
1Service de Cardiologie (Pr Thomas), Groupe Hospitalier Pitié-Salpétrière, Paris.
Presse Medicale (Paris, France : 1983)
|July 6, 1996
Summary
Shoshin beriberi, a severe heart failure from thiamine deficiency, is rare in Western countries but rapidly fatal if untreated. Early diagnosis and vitamin B1 therapy are crucial for alcoholic patients with heart failure.
Area of Science:
- Cardiology
- Nutritional Science
Context:
- Shoshin beriberi, a severe manifestation of thiamine deficiency, is an uncommon cause of acute heart failure and hemodynamic instability.
- Its low prevalence in Western countries can lead to delayed diagnosis.
Purpose:
- To highlight the characteristics, diagnosis, and management of shoshin beriberi.
- To emphasize the importance of considering this condition in at-risk populations.
Summary:
- Shoshin beriberi presents as acute global heart failure with lactic acidosis, often in chronic alcoholics.
- Diagnostic findings include normal ECG, pulmonary edema on chest X-ray, and potentially normal or abnormal echocardiography.
- Right heart catheterization reveals low cardiac output due to arteriovenous shunts; diagnosis is confirmed post-hoc by thiamine level tests.
Impact:
- Prompt intravenous vitamin B1 infusion leads to rapid clinical improvement.
- Regular vitamin B1 supplementation is recommended for undernourished alcoholic patients to prevent fulminant heart failure.