BERIBERI CARDIOMYOPATHY

In Indonesia beriberi is still endemic, but subclinical cases are not uncommon. Three patients suffering from beriberi presented with differ ent clinical manifestations. One had the classical features of Shoshin beriberi and the other two had the non-alcoholic cardiac beriberi (ch ronic type). The cardiac symptoms of all three patients responded dram atically to thiamine tetrahydrofurfuryl disulfide; there was also some improvement of their polyneuropathy, consistent with the neurophysiol ogic findings and somato-sensory evoked potentials (SSEPs). We conclud e that SSEPs provide additional clinical information on beriberi polyn europathy. The mortality of untreated cardiovascular beriberi is high. In view of the harmless nature of the treatment, a good case could be made for routine administration of thiamine to all patients in whom h eart failure is present without clear evidence of the cause.