Reversible severe resting pulmonary hypertension with right ventricular dysfunction associated with thiamine deficiency

Korean J Med > Volume 71(3); 2006 > Article

Original Article

The Korean Journal of Medicine 2006;71(3):1013-1016.

Reversible severe resting pulmonary hypertension with right ventricular dysfunction associated with thiamine deficiency

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이화여자대학교 의과대학 내과학교실

증례 : Thiamine 결핍에 의해 발생한 가역적인 중증 폐동맥 고혈압증 1예

박형서&#;박재형&#;정재욱&#;장원일&#;김은미&#;최시완&#;성인환, , , , , ,

Department of Internal Medicine, Ewha Womans University School of Medicine, Seoul, Korea

Abstract

The incidence of cardiac beriberi is rare in the developed countries. This disease can lead to high output cardiac failure that is totally different from the situation observed in alcoholic patients. We present an atypical case of cardiac beriberi with reversible right heart failure and severe pulmonary hypertension. A 57 years old man with schizophrenia was referred to our department for severe exertional dyspnea and generalized weakness. Echocardiography performed on admission showed right ventricular dysfunction and severe resting pulmonary hypertension. Contrast‐enhanced spiral computerized tomography of the chest was done to rule out pulmonary thromboembolism, and it revealed no evidence of embolic occlusion of the pulmonary arteries. For evaluating his decreased motor power of the lower extremities, nerve conduction velocity tests and electromyograms were performed; polyradiculoneuropathy was diagnosed. His condition was markedly improved and the right ventricular dysfunction was normalized after therapeutic use of intravenous thiamine. Cardiac beriberi was confirmed by the low serum thiamine level and therapeutic testing with thiamine.(Korean J Med 71:S1013-S1016, 2006)

Key Words: deficiency, Heart failure, Heart ventricles, Right, Hypertension, Pulmonary