J Cardiovasc Ultrasound.  2006 Sep;14(3):116-119.

A Case of Shoshin Beriberi Presenting as Acute Coronary Syndrome with Shock: Shoshin Beriberi Mimicking Acute Coronary Syndrome

• Kwon TJ
• Hwang JY
• Park SR
• Kang YR
• Lee HY
• Kwak CH
• Choi BR

Abstract

Cardiac beriberi is caused by thiamine deficiency. Shoshin beriberi is a rare and fulminant form of cardiac beriberi characterized by hypotension, high output heart failure, lactic acidosis and anuria. Without early recognition and immediate treatment, most of these patients will be fatal. Therefore clinical diagnosis of shoshin beriberi is most important in emergency situation. We report a case of shoshin beriberi with clinical features mimicking acute coronary syndrome. Fifty year old male patient with chronic alcoholism was presented with shock, hypoxia, right heart failure and severe acidosis. Electrocardiogram showed abnormal Q in V1-3 and mild ST elevation and level of troponin I was slightly elevated. All manifestations including lactic acidosis were dramatically subsided in 18 hours by thiamine infusion. Even in developed country, shoshin beriberi can be occurred in patients with malnutrition and/or chronic alcoholism and should be differentiated with acute coronary syndrome.

Keyword

Shoshin beriberi; Acute coronary syndrome; Alcoholism

MeSH Terms

Acidosis
Acidosis, Lactic
Acute Coronary Syndrome*
Alcoholism
Anoxia
Anuria
Beriberi*
Developed Countries
Diagnosis
Electrocardiography
Emergencies
Heart Failure
Humans
Hypotension
Male
Malnutrition
Shock*
Thiamine
Thiamine Deficiency
Troponin I
Thiamine
Troponin I