Beriberi: A Reversible Cause of Acute Severe Pulmonary Hypertension

Thiamine, also known as vitamin B1, plays a fundamental role in energy metabolism. The organs most sensitive to thiamine deficiency are the cardiovascular and nervous systems. The usual presentations include Wernicke's encephalopathy, polyneuropathy (known as "dry beriberi"), and the cardiovascular form (known as "wet beriberi"). Wet beriberi-induced acute severe pulmonary hypertension has rarely been previously described. Here we present a case of wet beriberi with severe right heart failure due to acute pulmonary hypertension. The underlying physiologic derangements dramatically improved after thiamine treatment. No other possible causes of pulmonary hypertension could be identified, with the exception of thiamine deficiency. This case illustrates the importance of considering wet beriberi as a possible cause of acute pulmonary hypertension with right heart failure.