Document Detail


A case of ST-elevation and nystagmus--when coronary thrombosis is not to blame.
MedLine Citation:
PMID:  19622676     Owner:  NLM     Status:  In-Process    
Abstract/OtherAbstract:
We present the case of a post-menopausal female who, following a prolonged period of vomiting and diarrhoea, presented acutely with Wernicke's; encephalopathy, chest pain, ST-segment elevation and congestive cardiac failure associated with hypotension. Coronary angiography demonstrated no abnormality. Haemodynamics improved significantly in the short-term following intravenous thiamine replacement, with complete resolution of all ST-segment abnormalities and normalization of left ventricular function at six-week follow-up. Shoshin beriberi in the context of metabolic alkalosis, secondary to severe electrolyte depletion, is exceptional and is a differential diagnosis to be considered in all malnourished patients presenting with symptoms and signs suggestive of an acute coronary syndrome, especially those with a history of alcohol-dependence.
Authors:
M J Daly; L J Dixon
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Publication Detail:
Type:  Journal Article     Date:  2009-07-21
Journal Detail:
Title:  QJM : monthly journal of the Association of Physicians     Volume:  102     ISSN:  1460-2393     ISO Abbreviation:  QJM     Publication Date:  2009 Oct 
Date Detail:
Created Date:  2009-09-24     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9438285     Medline TA:  QJM     Country:  England    
Other Details:
Languages:  eng     Pagination:  737-9     Citation Subset:  IM    
Affiliation:
The Heart Centre, Royal Victoria Hospital, Belfast, Northern Ireland, UK. michaeljdaly@hotmail.com
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