THE HEMODYNAMIC, HISTOPATHOLOGICAL AND HORMONAL FEATURES OF ALCOHOLIC CARDIAC BERIBERI

  • 1 January 1981
    • journal article
    • research article
    • Vol. 50  (200) , 359-375
Abstract
Cases (5) of cardiac beriberi occurring in chronic alcoholics were described. Clinical diagnosis was based on the presence of biventricular failure, low dietary intake of thiamine and the therapeutic response to oral thiamine. Complicating cardiac disease was excluded by hemodynamic studies, left ventriculography, coronary angiography and endomyocardial biopsy. Hemodynamic measurements including quantitative left ventriculography were reported. They indicated that left ventricular function was depressed despite elevated cardiac output. Biopsy material was studied by light microscopy and EM. No lesion specific to beriberi was detected by either technique although the biopsies were quantitatively abnormal. Histological changes resembled those in early reports based on necropsy material and consisted of vacuolation and intercellular edema in the early stages with myofiber hypertrophy, fibrosis and cellular infiltration in the chronic cases. The transketolase test and response to i.v. thiamine during catheter studies were valuable diagnostic tests. Plasma renin, angiotensin II and aldosterone levels were lower than in patients with low output heart failure. The incidence of cardiac beriberi appeared to be greater than generally realized.

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