Severe acidosis and hyperdynamic circulation in a 39-year-old alcoholic

Stephen W. Smith

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17 Scopus citations


A case of acute fulminant cardiovascular beriberi, or 'shoshin beriberi,' is presented. Beriberi is classified as 'dry' (neurologic) or 'wet' (cardiovascular) and may be mixed. 'Wet' beriberi refers to a spectrum of l clinical manifestations ranging from a hyperdynamic state with high output cardiac failure to fulminant failure with collapsed peripheral circulation, lactic acidosis, and shock. Beriberi is probably much more common than previously recognized. Beriberi is caused by thiamine deficiency and l should be suspected in alcoholics who present with unexplained lactic acidosis, a hyperdynamic state, high output cardiac failure, or cardiogenic shock without electrocardiographic (EKG) evidence of myocardial necrosis. Shoshin beriberi is rapidly fatal without immediate treatment with thiamine.

Original languageEnglish (US)
Pages (from-to)587-591
Number of pages5
JournalJournal of Emergency Medicine
Issue number4
StatePublished - Jul 1 1998


  • Acidosis
  • Beriberi
  • High output cardiac failure
  • Hyperdynamic circulation
  • Shock


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