title: Clinical diagnosis of cardiac beriberi.
abstract: The clinical features of 28 patients with biochemically proven cardiac beriberi were prospectively studied. 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. All patients showed a dramatic response to intravenous thiamine; in group 1 the hyperdynamic state resolved within hours and in group 2 there was an immediate rise in the blood pressure with gradual resolution of the acidosis in 6-8 hours. Two patients in whom the diagnosis was missed died soon after admission to hospital. 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 beriberi (shoshin beriberi).
authors.affiliation: Department of Medicine, University of Natal, Durban.
authors.forename: D P
authors.initials: DP
authors.lastname: Naidoo
authors.forename: V
authors.initials: V
authors.lastname: Gathiram
authors.forename: A
authors.initials: A
authors.lastname: Sadhabiriss
authors.forename: F
authors.initials: F
authors.lastname: Hassen
mesh_terms: D000142:Acidosis, Respiratory / Q000150:complications; D001602:Beriberi / Q000150:complications / Q000175:diagnosis*; D001775:Blood Circulation; D002303:Cardiac Output, Low / Q000175:diagnosis; D006331:Heart Diseases / Q000175:diagnosis* / Q000209:etiology; D006801:Humans; D013831:Thiamine / Q000008:administration & dosage; D013834:Thiamine Pyrophosphatase; D014174:Transketolase / Q000097:blood
chemical_list: D014174:Transketolase; D013834:Thiamine Pyrophosphatase; D013831:Thiamine