Goto Yuko, Awata Masaki, Uematsu Masaaki, Yano Masamichi, Morozumi Takakazu, Kotani Jun-ichi, Watanabe Tetsuya, Onishi Toshinari, Iida Osamu, Sera Fusako, Nanto Shinsuke, Nagata Seiki
Cardiovascular Division, Kansai Rosai Hospital, Inabaso 3-1-69, Amagasaki, Hyogo 660-8511.
J Cardiol. 2007 Jun;49(6):361-5.
A 44-year-old male was admitted to our hospital for dyspnea, associated with severe pulmonary hypertension. The patient fell into a shock state on the next day. Hemodynamic measurements revealed high output heart failure with low peripheral vascular resistance. We suspected shoshin beriberi, a fulminant form of cardiac beriberi, by ruling out other common causes of pulmonary hypertension. The rapid recovery after intravenous thiamine administration and the patient's history of improper diet strongly supported the diagnosis. The present case of shoshin beriberi complicating severe pulmonary hypertension shows that history taking is important in elucidating the etiology and selecting the correct treatment.
一名44岁男性因呼吸困难伴严重肺动脉高压入院。患者次日陷入休克状态。血流动力学测量显示为高输出量心力衰竭伴外周血管阻力降低。通过排除肺动脉高压的其他常见病因,我们怀疑是暴发性脚气性心脏病,即脚气病的一种暴发型。静脉注射硫胺素后迅速康复以及患者不当饮食史有力地支持了这一诊断。本例暴发性脚气病合并严重肺动脉高压表明,病史采集对于阐明病因和选择正确治疗方法很重要。