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Query: UMLS:C0018801 (heart failure)
72,216 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Shoshin beriberi, a fulminant form of heart failure due to thiamine deficiency has a different presentation to the classical form of beriberi heart failure. It is characterized by a cold periphery, low blood pressure, renal shutdown and a severe metabolic acidosis. The true incidence is unknown. Two patients were seen within a few months in a general hospital and in both dietary deficiency of thiamine was a major factor.
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PMID:Shoshin beriberi: an underdiagnosed condition? 377 18

This report describes a case of severe acidosis with cardiac failure due to alcohol in a black man. Treatment with parenteral thiamine produced a prompt response. Thiamine deficiency should be recognized as an important cause of lactic acidosis.
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PMID:Acute pernicious or fulminating beriberi with severe lactic acidosis. A case report. 407 32

Two patients suffering from cardiovascular beriberi presented with different clinical manifestations. One had the classical features of a high cardiac output with raised jugular venous pressure and gross oedema. The other was in fulminating heart failure with clinical evidence of a low cardiac output but no peripheral oedema. The latter type of beriberi (shoshin) is rare. Cardiovascular beriberi has a high mortality when untreated. Both patients responded dramatically to thiamine, and this emphasizes the importance of considering thiamine deficiency as a cause of heart failure even when the cardiac output is low.
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PMID:Cardiac beriberi: two modes of presentation. 557 54

A 57-year-old woman with Crow-Fukase syndrome presented thiamine deficiency and pulmonary hypertension of unknown etiology. After oral administration of prednisolone and thiamine, echocardiogram showed marked improvement of the pulmonary hypertension. To our knowledge, this is the first case of this syndrome associated with thiamine deficiency and precapillary pulmonary hypertension, which may play a role in the pathogenesis of polyneuropathy and heart failure of this syndrome.
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PMID:Thiamine deficiency and pulmonary hypertension in Crow-Fukase syndrome. 749 83

This study compared the thiamine status of 35 elderly hospital inpatients with cardiac failure (CF) with that of 35 elderly inpatients with other diagnoses (Non-CF). The CF group was then randomly allocated to CF1 group (thiamine treatment, 200 mg per day for 7 days), and CF2 group (non supplemented). The effect of the thiamine treatment on the cardiac failure course was examined. Although there was no significant difference in thiamine status between CF and Non-CF groups, 11.5% of the first group against only 6.0% of the second was deficient with the thiamine pyrophosphate stimulation effect (TPPE) test. The same trend was observed, if NYHA functional assessment was taken into account, thiamine deficiency was more frequent in class 4 than in class 3. No significant difference for thiamin status was observed in patients receiving furosemide treatment and those without furosemide treatment. Although vitamin treatment permitted a significant improvement in thiamine status, the course of the cardiopathy was not significantly different in CF1 (supplemented) and CF2 (non supplemented) groups. Whether systematic thiamine supplementation is indicated in CF patients requires further investigation.
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PMID:Thiamine status of elderly patients with cardiac failure including the effects of supplementation. 796 Apr 89

Necropsy studies suggest that thiamine deficiency is underdiagnosed in life, in part because the classical clinical presentations are uncommon. Anecdotal reports suggest that thiamine deficiency may contribute to the development of delirium, heart failure and peripheral neuropathy in elderly patients, but little systematic research has been reported. We examined thiamine levels in 36 consecutive non-demented, community-dwelling patients admitted to an acute geriatric unit. Marginal thiamine deficiency [thiamine pyrophosphate effect (TPPE) 15-24%] was present in 11 (31%) and definite thiamine deficiency (TPPE > 25%) in 6 (17%) patients. Delirium occurred in 6/19 (32%) patients with normal thiamine status and 13/17 (76%) thiamine-deficient patients (p < 0.025, chi 2 test). One or more other possible causes for delirium were present in all cases. One patient had ocular signs and a dramatic clinical response to vitamin B complex therapy. Absent ankle jerks were noted in 2/19 (10%) patients with normal thiamine status and 7/17 (41%) patients with thiamine deficiency (p = 0.06). There was no difference in anthropometric indices or in the prevalence of other nutrient deficiencies between the two groups. Thiamine deficiency is common in elderly patients admitted to hospital and may contribute to the development of delirium.
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PMID:Thiamine deficiency in hospitalized elderly patients. 803 99

High cardiac output failure/state (HCOF) is regular feature of some illnesses e.g. thiamine deficiency, hyperthyroidism, severe anemia, Paget's disease or arteriovenous fistulae. HCOF in multiple myeloma is reported quite rarely. 31-year-old man was admitted because of fatigue, dyspnea and subfebrilities. Heart rate was 116/min, sinus rythm blood pressure 110/60 mmHg. Chest film showed cardiomegaly with sings of interstitial pulmonary edema, echocardiography mild dilatation of the left ventricle with hyperkinetic wall motion and small pericardial effusion. Hemoglobin was 104 g/l, leukocyte count 13.5 x 10(9)/l with 30% of plasmatic cells. Serum protein electrophoresis demonstrated a monoclonal gammapathy, X ray studies of the skelet multiple osteolytic lesions. Diagnosis of plasmocytic leukemia-form of multiple myeloma was established and chemotherapy (vincristine + adriamycine + dexamethason) was started. Patient cardiac status deteriorated. Cardiac catheterisation demonstrated mean righ atrial pressure of 25 mmHg, mean pulmonary artery pressure of 28 mmHg and pulmonary artery wedge pressure of 24 mmHg. Co was 20.0 l/min (C.I. 11.5 l/min/m2). In continuing of chemotherapy and symptomatic therapy for heart failure patients status gradually improved and complete remission of the myeloma and normalisation of cardiac parameters was achieved. Heart failure in multiple myeloma patients has been attributed to amyloidosis of myocardium, hyperviscosity syndrome, co-existing CAD or anthracycline toxicity. HCOF should be considered in patients with clinical evidence of heart failure and normal left ventricular function.
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PMID:[Hypercirculatory heart failure in a patient with plasmacytic leukemia]. 855 97

Cardiovascular beriberi is a syndrome caused by thiamine deficiency and characterized by systemic vasodilatation, heart failure and lactic acidosis. The occurrence of heart failure and vasodilatation is yet unexplained: neither theoretical nor experimental data are known. In this article, it is suggested that a fall of cellular ATP levels causes heart failure and that the release of adenosine is the cause of vasodilatation.
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PMID:Hypothesis on cellular ATP depletion and adenosine release as causes of heart failure and vasodilatation in cardiovascular beriberi. 856 49

In two patients admitted to a geriatric ward cardiac failure was based on a thiamine deficiency (wet beri-beri). After supplementation with thiamine they recovered completely. The first patient had a insufficient diet of only canned food, whereas the second patient suffered from both alcoholism and insufficient nutrients. These geriatric patients suffered from a serious illness due to a combination of somatic, psychological, functional en social factors. Thiamine is a co-enzyme in many metabolic processes. A thiamine deficiency is defined as a serum concentration below 95 nmol/1. Other diseases associated with thiamine deficiency are the Wernicke-Korsakoff syndrome and peripheral polyneuropathy (dry beri-beri). Not only alcoholics but also elderly patients with malnutrition are at risk of thiamine deficiency and associated diseases. Do not hesitate to supplement thiamine in case of cardiac failure because of possible thiamine deficiency.
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PMID:[Failure in self care and heart failure, thiamine deficiency in geriatric patients]. 870 51

Shoshin beriberi, a uncommon cause of hemodynamic instability (or cardiac shock) and acute heart failure may go undiagnosed in Western countries where prevalence is low. This severe heart condition due to thiamine deficiency is rapidly fatal unless specific therapy is given. The most frequent cause in France is chronic alcoholism. There are no specific signs on the electrocardiogram in a patient with acute heart failure due to shoshin beriberi. The chest x-ray simply shows signs of pulmonary edema and heart enlargement. The echocardiography may be normal although hypokinesia and/or dilatation of the left ventricle (due to thiamine deficiency) are sometimes noted. Diagnosis is suspected in patients with chronic alcoholism who develop acute global heart failure with lactic acidosis. Right catheterism confirms low cardiac output resulting from arteriovenous shunts. Blood tests (red cell transacetolase activity, measurement of effect of pyrophosphatase, plasma and intraerythrocyte thiamine) confirm the diagnosis a posteriori. Clinical improvement is rapid after intravenous infusion of vitamin B1. The danger of fulminant beriberi heart failure in undernourished alcoholic patients emphasizes the need for regular prescription of vitamin B1.
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PMID:[Shoshin beriberi. A rapidly curable hemodynamic disaster]. 1160 66


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