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Cardiac Beriberi

Beriberi Heart Disease


Presentation

  • Due to the complex clinical presentation and to the lack of diagnostic tests, thiamine deficiency is still being missed, especially among non-alcoholics patients. We present two fatal cases of non - alcohol associated cardiac beriberi.[ncbi.nlm.nih.gov]
  • The first two cases presented classically while the third case came with an unusual presentation. Cardiac beriberi is an old disease in modern Bangkok which can present in as several different clinical patterns.[ncbi.nlm.nih.gov]
  • Abstract Two patients suffering from cardiovascular beriberi presented with different clinical manifestations. One had the classical features of a high cardiac output with raised jugular venous pressure and gross oedema.[ncbi.nlm.nih.gov]
  • A rationalisation of the 1350 boxes used throughout the book gives a simpler and clearer presentation of the various categories.[books.google.ro]
  • Patients recruited over a 2-year-period fell into two groups: (i) those with signs of hyperdynamic circulation; and (ii) those presenting with heart failure and circulatory shock with or without metabolic acidosis.[ncbi.nlm.nih.gov]
Malnutrition
  • In industrial countries, not only alcoholics, but also deprived people with malnutrition, elderly patients and patients with AIDS are at risk of thiamine deficiency.[ncbi.nlm.nih.gov]
  • , 2018 , 161 CrossRef 2 Derrick Lonsdale , Chandler Marrs , Thiamine Deficiency Disease, Dysautonomia, and High Calorie Malnutrition, 2017 , 263 CrossRef 3 Thiamine Deficiency Disease, Dysautonomia, and High Calorie Malnutrition, 2017 , xi CrossRef 4[onlinelibrary.wiley.com]
  • Beriberi was a disease of malnutrition caused by the consumption of overmilled rice.[dictionary.cambridge.org]
  • FEX: Thiamine content of F-75 for complicated severe acute malnutrition: time for a change? Summary of research1 Location: Global What we know: Complicated cases of severe acute malnutrition (SAM) are usually severely ill with comorbidities.[ennonline.net]
Congestive Heart Failure
  • Moreover, long-term furosemide use may be associated with thiamine deficiency through urinary loss, contributing to cardiac insufficiency in patients with congestive heart failure.[ncbi.nlm.nih.gov]
  • On initial examination; the patient was in respiratory distress clinically, secondary to congestive heart failure, with peripheral edema and tachycardia.[medicalnewsbulletin.com]
  • Patients present with an enlarged heart, tachycardia, high-output congestive heart failure, peripheral edema, and peripheral neuritis.[jdrntruhs.org]
  • Complications may include: Coma Congestive heart failure Death Psychosis Beriberi is extremely rare in the United States.[medlineplus.gov]
  • The clinical disease, beri-beri, is divided into a “wet” form, which causes congestive heart failure, and a “dry” form, which causes neurologic disease in the form of peripheral neuropathy and Wernicke-Korsakoff syndrome. beri-beri Nutrition A disease[medical-dictionary.thefreedictionary.com]
Hypoxemia
  • However, 5 days after the shock, hypoxemia and diffuse radiographic infiltrates progressed, and a diagnosis of adult respiratory distress syndrome (ARDS) was made. After the occurrence of an air leak, the patient died of respiratory failure.[ncbi.nlm.nih.gov]
Prisoner of War
  • A case is described of an Englishman who suffered severe 'wet beriberi' whilst a prisoner of war (POW) of the Japanese in World War II. 2.[ncbi.nlm.nih.gov]
  • A case is described of an Englishman who suffered severe ‘wet beriberi’ whilst a prisoner of war (POW) of the Japanese in World War II. 2.[cambridge.org]
Tachypnea
  • Majority presented with tachypnea, chest indrawing and tachycardia and cardiomegaly with dilatation of right heart and pulmonary hypertension on 2D-echocardiography.[ncbi.nlm.nih.gov]
  • All of them presented with tachypnea, chest indrawing and tachycardia.[academic.oup.com]
  • Respiratory system examination revealed tachypnea and on auscultation there were bilateral basal fine crepitations, electrocardiogram showed T wave inversions. Abdominal examination revealed tender hepatomegaly.[jdrntruhs.org]
  • Recent surveys using whole blood thiamine diphosphate (TDP) revealed that thiamine deficiency was associated with cardiac dysfunction and tachypnea in Cambodian infants [ 32, 34 ].[journals.plos.org]
Tachycardia
  • Shoshin beriberi is characterized by hypotension, tachycardia, and lactic acidosis and is mainly encountered in non-alcoholic patients in Asian countries, although it has also been seen in alcoholics in Western countries.[ncbi.nlm.nih.gov]
  • Majority presented with tachypnea, chest indrawing and tachycardia and cardiomegaly with dilatation of right heart and pulmonary hypertension on 2D-echocardiography.[ncbi.nlm.nih.gov]
  • All of them presented with tachypnea, chest indrawing and tachycardia.[academic.oup.com]
  • On initial examination; the patient was in respiratory distress clinically, secondary to congestive heart failure, with peripheral edema and tachycardia.[medicalnewsbulletin.com]
Heart Disease
  • She developed hyponatremia and beriberi heart disease, which resulted in metabolic acidosis and cardiogenic shock (shoshin beriberi). Mechanical ventilation was applied for pulmonary edema.[ncbi.nlm.nih.gov]
  • The cases cover a spectrum of beriberi heart disease ranging from a hyperdynamic circulation to circulatory shock.[ncbi.nlm.nih.gov]
  • Beriberi heart disease in Durban. A retrospective study. S Afr Med J 1987;72:241–244.[synapse.koreamed.org]
  • Beriberi heart disease may cause sudden cardiac dysfunction within days of onset of symptoms.[wikidoc.org]
Femoral Bruit
  • A notable finding was that even in the presence of peripheral circulatory shock, patients with beriberi had preservation of the femoral pulses often with 'pistol shots' and femoral bruit; this finding has clinical value in the diagnosis of acute cardiovascular[ncbi.nlm.nih.gov]
Pansystolic Murmur
  • Cardiovascular system examination revealed a third heart sound along with first and second heart sounds, and a grade 3/6 pansystolic murmur was heard all over precordium.[jdrntruhs.org]
Anger
  • Seite 147 - DV, Angerer, LM, and Angerer, RC (1984) Detection of mRNAs in sea urchin embryos by in situ hybridization using asymmetric RNA probes. Dev. Biol. 101, 485-502. ‎[books.google.de]
  • Pagina 147 - DV, Angerer, LM, and Angerer, RC (1984) Detection of mRNAs in sea urchin embryos by in situ hybridization using asymmetric RNA probes. Dev. Biol. 101, 485-502. ‎[books.google.ro]
Impulsivity
  • […] examination revealed pulse rate was 100/min, regular high volume, collapsing and pistol shot sounds were heard over large arteries, blood pressure was 80/10 mm of Hg, temperature was 100 F, jugular venous pressure was elevated with prominent "V" wave, apical impulse[jdrntruhs.org]

Workup

  • (See Pathophysiology, Etiology, Presentation, and Workup.) [6, 7] Dietary thiamine Food that are rich in thiamine are as follows [1] (see Table 1, below): Whole-grain foods Meat/fish/poultry/eggs Milk and milk products Vegetables (ie, green, leafy vegetables[emedicine.medscape.com]
Enlargement of the Liver
  • There was a tender, enlarged and palpable liver below the right costal margin, but shifting dullness or visualized distended veins on the abdominal wall were not observed. The spleen was not palpable.[synapse.koreamed.org]
Mycobacterium Avium Complex
  • Seite 370 - Recommendations on prophylaxis and therapy for disseminated Mycobacterium avium complex disease in patients infected with the human immunodeficiency virus. ‎[books.google.de]
  • Pagina 370 - Recommendations on prophylaxis and therapy for disseminated Mycobacterium avium complex disease in patients infected with the human immunodeficiency virus. ‎[books.google.ro]
Premature Atrial Contractions
  • ECG on admission revealed premature atrial contraction with nonspecific ST-T change. Chest radiography showing cardiomegaly with mild pulmonary congestion and pleural effusion. Transthoracic echocardiography.[synapse.koreamed.org]
Prominent V-Waves
  • "V" wave, apical impulse was felt in sixth intercostal space.[jdrntruhs.org]

Treatment

  • Treatment consists of thiamine administration with rapid clinical improvement after supplementation.[ncbi.nlm.nih.gov]
  • We herein present one case of cardiac beriberi in which optimal and timely treatment induced dramatic improvement in left ventricular (LV) systolic function.[synapse.koreamed.org]
  • The disorder is a metabolic emergency and requires immediate treatment with intravenous thiamine. Sudden cardiac failure is common. Death occurs from right heart failure and the patient usually dies fully conscious.[jdrntruhs.org]
  • Treatments & Home Remedies for Beriberi Medical Treatments For the treatment of beriberi, doctors generally prescribe thiamine shots or pills.[organicfacts.net]
  • […] of thiamine deficiency thiamine 100 mg orally daily Prevention and treatment of thiamine deficiency in severe alcoholics thiamine 100 to 200 mg IV daily for 3 days then thiamine 100 mg orally daily Treatment of Wernicke encephalopathy thiamine 500 mg[lifeinthefastlane.com]

Prognosis

  • Treatment and prognosis Optimal treatment of beriberi relies upon a two-pronged approach: thiamine supplementation supportive therapies e.g. cardiac support Recovery is often rapid once thiamine supplements are started.[radiopaedia.org]
  • Prognosis The prognosis for beriberi is usually good, unless patients have established Korsakoff syndrome. When patients have progressed to this stage, the degree of damage is only minimally reversible.[namrata.co]
  • Prognosis Mortality is rare and is usually associated with the wet form due to cardiac failure. [ 26 ] Morbidity is also rare and usually presents in the dry form with neurological symptoms.[patient.info]
  • Prognosis Beriberi is fatal if not treated and the longer the deficiency exists, the sicker the person becomes.[encyclopedia.com]
  • If patients with alcoholic cardiomyopathy do not abstain from alcohol, they have a poorer prognosis and significantly higher mortality rates compared with those who do abstain. The 4-year mortality can be as high as 50% [ 2, 13 ].[oapublishinglondon.com]

Etiology

  • The nature of the disorder, certain symptoms of which started in infancy, was such that it strongly indicated a metabolic rather than a nutritional etiology, involving energy metabolism.[link.springer.com]
  • Any factor leading to an increased thiamine demand may be etiological. For example, young men are often affected possibly because they work hardest.[jdrntruhs.org]
  • In lactic acidosis and/or hyperdynamic circulation without any other apparent etiology in patients with possible vitamin B1 deficiency, the diagnosis of BB must be considered and thiamine should be administered.[ncbi.nlm.nih.gov]
  • Etiology In general, those individuals with a poor diet are most likely to develop thiamine deficiency.[radiopaedia.org]
  • Currently, the diagnosis of this disease depends on the following three factors: 1) clinical symptoms related to heart failure and a characteristic history of dietary inadequacy in combination with excessive alcohol intake, 2) exclusion of other etiologic[synapse.koreamed.org]

Epidemiology

  • It is caused by severe thiamine deficiency. [1] Epidemiology and Demographics This disease is most prevalent in the Far East, however, in the past decade its prevalence has markedly decreased.[wikidoc.org]
  • […] concurrently, including Wernicke's encephalopathy (mainly affecting the central nervous system), Korsakoff's syndrome (amnesia with additional psychiatric manifestations), and Wernicke-Korsakoff syndrome (with both neurologic and psychiatric symptoms) Epidemiology[flipper.diff.org]
  • Another translation is 'I cannot, I cannot'. [ 2 ] Epidemiology Beriberi was endemic in some areas of the world and may be related to the consumption of milled rice.[patient.info]
  • Greater recognition of the spectrum of thiamine deficiency should enable the supporting science to move beyond descriptive epidemiology to implement prevention and control in vulnerable populations worldwide.[ajcn.nutrition.org]
  • We adapted our definitions of thiamine deficiency cases from 2 surveys: one hospital-based survey and one epidemiological outbreak survey [ 36, 40 ].[journals.plos.org]
Sex distribution
Age distribution

Pathophysiology

  • The disease is also common in fad diet appliers. [2] Pathophysiology Pathologically the heart in cardiac beriberi is most often hypertrophied and dilated, with involvement of both the right and left chambers.[wikidoc.org]
  • Pathophysiology Thiamine in the human body has a half-life of 18 days and is quickly exhausted, particularly when metabolic demands exceed intake.[flipper.diff.org]
  • (See Pathophysiology, Etiology, Presentation, and Workup.) [6, 7] Dietary thiamine Food that are rich in thiamine are as follows [1] (see Table 1, below): Whole-grain foods Meat/fish/poultry/eggs Milk and milk products Vegetables (ie, green, leafy vegetables[emedicine.medscape.com]
  • Attas M, Hanley HG, Stultz D (1978) Fulminant beri beri heart disease with lactic acidosis: presentation of a case with evaluation of left ventricular function and review of pathophysiologic mechanisms. Circulation 58:566–572 Google Scholar 4.[link.springer.com]

Prevention

  • Also known as aneurin, this vitamin helps prevent neuritic and beriberi. B1 vitamin benefits include prevention of severe eye fatigue and neurodegeneration.[newsmax.com]
  • In 2014, Save The Children commissioned Burnet to carry out a technical review of the evidence for the prevention of infantile beriberi to stimulate discussion and to advocate for prevention strategies in Lao PDR.[burnet.edu.au]
  • Article navigation 1From the Divisions for Heart Disease and Stroke Prevention (BAB) and Reproductive Health (WDB), National Center for Chronic Disease Prevention and Health Promotion, Atlanta, GA; and the Nutritional Biomarkers Branch, Division of Laboratory[ajcn.nutrition.org]
  • Thiamine before glucose to prevent Wernicke encephalopathy: examining the conventional wisdom. JAMA. 1998 Feb 25;279(8):583-4.[lifeinthefastlane.com]
  • A healthy diet that is rich in rice can always help you prevent beriberi. Rice Bran This is the best-known remedy for beriberi and has been practiced for hundreds of years.[organicfacts.net]

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