A Rare Case of Rapidly Progressing Beriberi Heart

A 67-year-old man with schizophrenia was admitted
to our hospital complaining of nausea and leg
edema, and fell into a shock state the same day.
The blood tests revealed high levels of the troponin
I （5.2 ng/mL） and transthoracic echocardiography
showed left ventricular （LV） dilatation and wall
motion abnormality, he was suspected of acute heart
failure caused by coronary artery disease. But coronary
angiography showed no significant coronary
arterial stenosis. The cardiac output was high and
peripheral vascular dilatation occurred, he was treated
supported by noradrenaline, but he passed away
on the third day. He did not receive supplement of
thiamine during this period without being given a
diagnosis because he worsened rapidly. Myocardial
necrosis and colliquative myocytolysis were observed
in the autopsy. The thiamine level at admission was
proven to be low, and was diagnosed as shoshin
beriberi.