Beriberi Induced Cardiomyopathy Requiring Salvage Venoarterial Extracorporeal Membrane Oxygenation

Shah, Aditya; Patel, Samir; Kothari, Sorabh; Denk, Jennifer

doi:10.1155/2016/5043818

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Beriberi Induced Cardiomyopathy Requiring Salvage Venoarterial Extracorporeal Membrane Oxygenation

case-report

Author(s): Aditya Shah ¹ ^, ² ^, ^* , Samir Patel ² , Sorabh Kothari ¹ ^, ² , Jennifer Denk ²

Publication date (Electronic): 5 December 2016

Journal: Case Reports in Critical Care

Publisher: Hindawi Publishing Corporation

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Abstract

Beriberi refers to a constellation of symptoms caused primarily by thiamine (vitamin B1) deficiency. An acute and fulminant presentation of this rare condition has been described in the literature as “Shoshin” beriberi which is characterized by catastrophic cardiovascular collapse. Early recognition and treatment lead to dramatic improvements of symptoms. We present a case of thiamine deficiency-induced acute heart failure in a malnourished patient leading to cardiac arrest necessitating VA-ECMO (venoarterial extracorporeal membrane oxygenation) with improvement in heart function secondary to thiamine administration.

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Most cited references 10

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Cardiac beriberi: often a missed diagnosis.

Prakash G. Chandak, P. Rao (2010)

Thiamine deficiency leads to various manifestations due to dysfunction of nervous or cardiovascular system, commonly known as dry and wet beriberi, respectively. The latter, also known as cardiac beriberi is usually missed in clinical practice because of the absence of classically described symptoms such as pedal edema/anasarca. We investigated 55 such infants and prospectively followed their clinical course. All the babies were exclusively breast-fed and their mothers belonged to low socio-economic status with their staple diet consisting of non-parboiled polished rice. Majority presented with tachypnea, chest indrawing and tachycardia and cardiomegaly with dilatation of right heart and pulmonary hypertension on 2D-echocardiography. Low levels of erythrocyte transketolase activity suggested thiamine deficiency that was confirmed by reversion of several clinical features including cardiologic abnormalities to normalcy on thiamine supplementation. We recommend thiamine therapy for infants with unexplained congestive cardiac failure or acute respiratory failure from precarious socio-economic background since it is life-saving in many instances.

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Shoshin Beriberi in Critically-Ill patients: case series

George Dabar, Carine Harmouche, Bassem Habr … (2015)

Thiamine plays a fundamental role in cellular metabolism. The classical syndrome caused by thiamine deficiency is beriberi, and its fulminant variant, once considered an uncommon finding, is now encountered among the critically ill. We present a case series of four critically ill non-septic non-alcoholic patients with severe lactic acidosis and refractory cardio-circulatory collapse caused by acute fulminant beriberi, which drastically responded to thiamine administration. In critical care settings, increased awareness of this life-threatening but reversible condition is a requirement, especially among patients receiving parenteral nutrition and those with unexplained recalcitrant lactic acidosis.

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Gastrointestinal beriberi: a previously unrecognized syndrome.

Michael W. Donnino (2004)

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Author and article information

Journal

Journal ID (nlm-ta): Case Rep Crit Care

Journal ID (iso-abbrev): Case Rep Crit Care

Journal ID (publisher-id): CRICC

Title: Case Reports in Critical Care

Publisher: Hindawi Publishing Corporation

ISSN (Print): 2090-6420

ISSN (Electronic): 2090-6439

Publication date (Print): 2016

Publication date (Electronic): 5 December 2016

Volume: 2016

Electronic Location Identifier: 5043818

Affiliations

¹University of Illinois at Chicago, Chicago, IL, USA

²Advocate Christ Medical Center, Oak Lawn, IL, USA

Author notes

*Aditya Shah: aditya.shah@ 123456advocatehealth.com

Academic Editor: Ricardo Oliveira

Author information

Aditya Shah http://orcid.org/0000-0001-5921-604X

Article

DOI: 10.1155/2016/5043818

PMC ID: 5165147

SO-VID: 4674a79b-e998-4095-8850-ea5f02473e43

License:

This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.