Physiologic observations on a case of beriberi heart disease, with a note on the acute effects of thiamine

Abstract

TWENTY-NINE year old white, alcoholic A male entered the hospital with all of the features of circulatory congestion of the type associated with beriberi. He showed massive edema and ascites, a dusky plethora with hot extremities and an overactive heart. The antecubital venous pressure was 310 mm. Hz0 and the calcium gluconate circulation time was 9 seconds arm-to-tongue. An electrocardiogram and the size and configuration of the heart by x-ray were normal. The serum proteins were normal and there was mild anemia. Subsequent liver function studies and liver biopsy revealed moderate portal cirrhosis. He had been drinking for several years, more heavily for the past two months, and his dietary intake had been extremely poor during this entire period. As nearly as could be determined, he had consumed only alcoholic beverages during the past six weeks. The patient was placed on a thiamine deficient diet without salt restriction and kept at normal activity. The first physiologic study was carried out twelve hours after admission.