大倉 宏之¹, 吉田 清¹, 赤阪 隆史¹, 穂積 健之¹, 高木 力¹, 盛岡 茂文¹, 吉川 純一²

Hiroyuki OKURA¹, Kiyoshi YOSHIDA¹, Takashi AKASAKA¹, Takeshi HOZUMI¹, Tsutomu TAKAGI¹, Shigefumi MORIOKA¹, Junichi YOSHIKAWA²

¹神戸市立中央市民病院循環器センター内科, ²大阪市立大学第一内科

¹Division of Cardiology, Kobe General Hospital, ²First Department of Internal Medicine, Osaka City University Medical School

キーワード : Beriberi, Diastolic function, Doppler echocardiography, High-output heart failure

A 54-year-old man was hospitalized with respiratory failure. Arterial blood gases showed severe metabolic acidosis at the time of admission, and chest X-ray films disclosed cardiac enlargement and increased pulmonary markings. Two-dimensional and Doppler echocardiogram showed hyperkinetic heart motion and pulmonary hypertension; left ventricular diastolic function assessed by left ventricular inflow pattern was normal; and right-heart catheterization revealed high-output status and pulmonary hypertension. A diagnosis of shoshin beriberi was made. Pulmonary congestion disappeared after administration of thiamine, and output status returned to normal. Left ventricular inflow pattern showed an abnormal relaxation pattern when systemic vascular resistance and blood pressure were elevated. Left ventricular inflow pattern returned to normal as blood pressure normalized after vasodilator administration. Thus, two-dimensional and Doppler echocardiography may prove useful in serial assessment of systolic and diastolic function in patients with shoshin beriberi.