Circulation Journal
Online ISSN : 1347-4820
Print ISSN : 1346-9843
ISSN-L : 1346-9843
Case Report
Shoshin Beriberi With Vasospastic Angina Pectoris Possible Mechanism of Mid-Ventricular Obstruction
Masahiro ItoYasuhiko TanabeKaoru SuzukiMakoto KumakuraYoshifusa Aizawa
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2002 Volume 66 Issue 11 Pages 1070-1072

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Abstract

A 73-year-old heavy drinker was admitted to hospital in a state of shock. He had been suffering from frequent angina at rest, causing him to drink more heavily in an effort to overcome his anginal chest pain. He had been drinking hard each day and had not eaten for 4 weeks. His hemodynamic state on admission showed high-output heart failure. Echocardiography revealed hyperkinesis of the left ventricle and mid-ventricular obstruction with peak intraventricular gradients of 30 mmHg. Although no improvement was seen despite administering the maximal dose in catecholamine therapy, his condition improved rapidly after vitamin B1 was administered. Cardiac catheterization revealed mid-ventricular obstruction with an apical aneurysm. Coronary artery spasm was induced by injecting acetylcholine in the distal site of the left anterior descending artery, which perfused the area of the apical aneurysm. In the present case, both left ventricular hyperkinesis caused by shoshin beriberi and apical myocardial infarction caused by frequent coronary spasms produced mid-ventricular obstruction with an apical aneurysm. (Circ J 2002; 66: 1070 - 1072)

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© 2002 THE JAPANESE CIRCULATION SOCIETY
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