Serial electrocardiographic changes in cardiac beriberi

Abstract

Serial electrocardiograms (ECG) before and after treatment were obtained on 8 patients suffering from cardiac beriberi. One patient was admitted twice. All of the patients had sinus rhythm. Sinus tachycardia was observed twice. No patient had a cardiac arrhythmia. The P-R intervals were normal as were the QRS complexes. A prolonged Q-T interval was observed twice on the control ECG. After thiamine hydrochloride therapy, transient increases in the P-R and the Q-T intervals were not uncommon. QRS axis in the frontal plane was normal in all of the patients and showed no significant changes after treatment. It also showed no correlation with the degree of pulmonary hypertension in patients on whom hemodynamic studies were performed. T wave abnormalities such as low voltage diphasic or inverted T waves were observed in 5 patients, 3 of whom showed even more abnormality after the treatment. In 4 patients with marked cardiomegaly on admission a striking increase in the QRS voltage, as well as marked reduction in the cardiac size, was observed after recovery. All ECGs returned to normal or almost normal after the patients recovered. The changes in heart size and in ECG voltages appear similar to those observed in patients with pericardial effusion.