Wet beri-beri
This form of beriberi is characterised by oedema.
The aetiology of the oedema is twofold:
- lactate and pyruvate accumulate in the blood and cause vasodilatation and increased extravasation of fluid into the tissues
- the cardiomyopathy of thiamine deficiency causes heart failure
Clinically, the patient has warm, oedematous peripheries with a fast, bounding pulse. Central venous pressure is raised but cardiac output falls, resulting in heart failure. The ECG may show conduction abnormalities.
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