A case of cardiac beriberi: a forgotten but memorable disease

Abstract

Thiamine (vitamin B1) serves as an important cofactor in body metabolism and energy production. It is related with the biosynthesis of neurotransmitters and the production of substances used in defense against oxidant stress. Thus, a lack of thiamine affects several organ systems, in particular the cardiovascular and nervous system. The cardiac insufficiency caused by thiamine deficiency is known as cardiac beriberi, with this condition resulting from unbalanced nutrition and chronic excessive alcohol intake. Given that the disease is now very rare in developed nations such as Korea, it is frequently missed by cardiologists, with potentially fatal consequences. Herein, we present a case study in order to draw attention to cardiac beriberi. We believe that this case will be helpful for young cardiologists, reminding them of the importance of this forgotten but memorable disease.

Keywords: Beriberi, heart failure; Thiamine deficiency.

Fig. 1

Electrocardiography (ECG). ECG on admission revealed premature atrial contraction with nonspecific ST-T change.

Fig. 2

Chest radiography showing cardiomegaly with mild pulmonary congestion and pleural effusion.

Fig. 3

Transthoracic echocardiography. A: dilated LV cavity and depressed systolic function (Initial). B: moderate to severe functional MR and TR (Initial). C: improved LV size and heart function (6 months later). D: mild MR (6 months later). LV: left ventricule, MR: mitral regurgitation, TR: tricuspid regurgitation.

Fig. 4

Cardiac magnetic resonance imaging. This shows left ventricular dilatation without delayed enhancement, confirming dilated CMP and excluding ischemic CMP. CMP: cardiomyopathy.