Abstract
Physiologic observations on myocardial performance and coronary circulation were obtained in an alcoholic noncirrhotic subject with beriberi heart disease who developed low cardiac output failure shortly after successful treatment with thiamine. The initial cardiac study revealed biventricular failure, high cardiac index, low peripheral resistance, and increased coronary blood flow with a narrow myocardial arteriovenous oxygen difference. Neither exercise nor ouabain was effective in restoring circulatory dynamics toward normal. Thiamine improved myocardial function not only at rest, but also during exercise. During the state of low output failure, biventricular failure with low cardiac index and elevated peripheral resistance was observed. Coronary blood flow and myocardial oxygen consumption were normal. Exercise and thiamine were without effect; ouabain improved myocardial response to exercise.
Published Version
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