High Minute Volume Pulmonary Hypertension Reversed By Thiamine Administration In Wet Beriberi

Introduction: Beriberi is a hypovitaminosis secondary to thiamine deficiency (vitamin B1). At the pulmonary level, could present with Pulmonary Hypertension (PH). Case Report: 54-year-old female, with past medical history of irritable bowel diagnosis for which she did not make an adequate diet. She presents to clinic for one month of progressive dyspnea evolution to CF II / III. On physical examination: hemodynamically stable, she presented 2/6 edemas in four limbs, 2/3 jugular ingurgitation, abdominal pain in the right hypochondrium and left flank. In complementary tests, anemia (Hb: 10.4 g / dl) and elevated biomarkers (Troponin T: 36U, ProBNP: 6744 U.) were found. The echocardiogram compatible with pulmonary hypertension. Chest radiography and spirometry were normal. DLCO 55% and 6MWT: 360 mts. without desaturation. A CT angiography ruled out pulmonary thromboembolism, the Pulmonary Artery / Aorta ratio> 0.9 and a VD / VI ratio> 0.9. Given these findings a right heart catheterization was performed: RAP:6 mm Hg; PAP: 40/27(mean 35) mm Hg.; PCWP: 12 mm Hg; Cardiac output: 7.2 l / m; Cardiac Index: 3.3 l / m / m2; PVR: 3.3 U Woods. Upper digestive endoscopy was performed with duodenal biopsy that showed villous atrophy. With the diagnosis of high-flow heart failure, a diagnosis of Beriberi was suspected, dosing of vitamin B1 and B12 was performed, which were decreased and treatment with B complex began. after three months she presented normalization of clinical symptoms, echocardiogram,and NMR. Conclusions: In cases of PH with high minute volume, the diagnosis of Beriberi should be suspect, since it is a totally reversible with vitamin B supplementation.