Cardiovascular magnetic resonance in wet beriberi

Essa Essa, Michael R. Velez, Sakima Smith, Shivraman Giri, Subha V. Raman, Richard J. Gumina

Research output: Contribution to journalArticle

13 Citations (Scopus)

Abstract

The clinical presentation of beriberi can be quite varied. In the extreme form, profound cardiovascular involvement leads to circulatory collapse and death. This case report is of a 72 year-old male who was admitted to the Neurology inpatient ward with progressive bilateral lower extremity weakness and parasthesia. He subsequently developed pulmonary edema and high output cardiac failure requiring intubation and blood pressure support. With the constellation of peripheral neuropathy, encephalopathy, ophthalmoplegia, unexplained heart failure, and lactic acidosis, thiamine deficiency was suspected. He was empirically initiated on thiamine replacement therapy and his thiamine level pre-therapy was found to be 23 nmol/L (Normal: 80-150 nmol/L), consistent with the diagnosis of beriberi. Cardiovascular magnetic resonance (CMR) showed severe left ventricular systolic dysfunction, markedly increased myocardial T2, and minimal late gadolinium enhancement (LGE). After 5 days of daily 100 mg IV thiamine and supportive care, the hypotension resolved and the patient was extubated and was released from the hospital 3 weeks later. Our case shows via CMR profound myocardial edema associated with wet beriberi.

Original languageEnglish (US)
Article number41
JournalJournal of Cardiovascular Magnetic Resonance
Volume13
Issue number1
DOIs
StatePublished - Dec 1 2011

Fingerprint

Beriberi
Thiamine
Magnetic Resonance Spectroscopy
Heart Failure
Thiamine Deficiency
Ophthalmoplegia
Lactic Acidosis
Gadolinium
Brain Diseases
Left Ventricular Dysfunction
Peripheral Nervous System Diseases
Pulmonary Edema
Neurology
Intubation
Hypotension
Inpatients
Lower Extremity
Shock
Edema
Blood Pressure

ASJC Scopus subject areas

  • Radiological and Ultrasound Technology
  • Radiology Nuclear Medicine and imaging
  • Cardiology and Cardiovascular Medicine

Cite this

Essa, E., Velez, M. R., Smith, S., Giri, S., Raman, S. V., & Gumina, R. J. (2011). Cardiovascular magnetic resonance in wet beriberi. Journal of Cardiovascular Magnetic Resonance, 13(1), [41]. https://doi.org/10.1186/1532-429X-13-41

Cardiovascular magnetic resonance in wet beriberi. / Essa, Essa; Velez, Michael R.; Smith, Sakima; Giri, Shivraman; Raman, Subha V.; Gumina, Richard J.

In: Journal of Cardiovascular Magnetic Resonance, Vol. 13, No. 1, 41, 01.12.2011.

Research output: Contribution to journalArticle

Essa, E, Velez, MR, Smith, S, Giri, S, Raman, SV & Gumina, RJ 2011, 'Cardiovascular magnetic resonance in wet beriberi', Journal of Cardiovascular Magnetic Resonance, vol. 13, no. 1, 41. https://doi.org/10.1186/1532-429X-13-41
Essa, Essa ; Velez, Michael R. ; Smith, Sakima ; Giri, Shivraman ; Raman, Subha V. ; Gumina, Richard J. / Cardiovascular magnetic resonance in wet beriberi. In: Journal of Cardiovascular Magnetic Resonance. 2011 ; Vol. 13, No. 1.
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