fursultiamin and Cardiomyopathies

We report a case of a 58-year-old man with Shoshin beriberi who demonstrated ST-segment elevation and myocardial damage without coronary artery stenosis. The patient subsequently recovered with thiamine treatment. We conclude that it is important to consider Shoshin beriberi as part of the differential diagnosis in patients with shock and ST-segment elevation.

Topics: Beriberi; Cardiac Catheterization; Cardiomyopathies; Coronary Angiography; Diagnosis, Differential; Electrocardiography; Follow-Up Studies; Fursultiamin; Gated Blood-Pool Imaging; Humans; Injections, Intravenous; Male; Middle Aged

In Indonesia beriberi is still endemic, but subclinical cases are not uncommon. Three patients suffering from beriberi presented with different clinical manifestations. One had the classical features of Shoshin beriberi and the other two had the non-alcoholic cardiac beriberi (chronic type). The cardiac symptoms of all three patients responded dramatically to thiamine tetrahydrofurfuryl disulfide; there was also some improvement of their polyneuropathy, consistent with the neurophysiologic findings and somatosensory evoked potentials (SSEPs). We conclude that SSEPs provide additional clinical information on beriberi polyneuropathy. The mortality of untreated cardiovascular beriberi is high. In view of the harmless nature of the treatment, a good case could be made for routine administration of thiamine to all patients in whom heart failure is present without clear evidence of the cause.

Topics: Adult; Beriberi; Cardiomyopathies; Cardiomyopathy, Alcoholic; Evoked Potentials, Somatosensory; Fursultiamin; Humans; Male; Middle Aged; Peripheral Nervous System Diseases