Intended for healthcare professionals

CCBYNC Open access
Research

Association between clinically recorded alcohol consumption and initial presentation of 12 cardiovascular diseases: population based cohort study using linked health records

BMJ 2017; 356 doi: https://doi.org/10.1136/bmj.j909 (Published 22 March 2017) Cite this as: BMJ 2017;356:j909

Re: Association between clinically recorded alcohol consumption and initial presentation of 12 cardiovascular diseases: population based cohort study using linked health records

Wernicke’s encephalopathy (WE) is a neurological disorder caused by thiamine (vitamin B1) deficiency. It mainly occurs in alcoholic patients but can also be caused by other circumstances, such as inadequate diet, prolonged parenteral nutrition, vomiting and other gastrointestinal disorders, or increased metabolic needs [1]. Classic clinical presentation is the triad of altered mental status, oculomotor dysfunction, and ataxic gait. However, it can often present differently and may even be associated with cardiovascular symptoms brought on by the same vitamin deficiency, which is known as “wet beriberi” [2].

In such cases there is pericardial edema due to accumulation of pyruvic acid and lactice acid know to cause vaso-dilation.

Acetyl Co A <-------PDH------------------------Pyruvic acid <--------LDH------------> Lactic acid. Conversion to Acetyl Co A is inhibited and Pyruvic acid and lactic acid accumulate.
Sometimes thiamin administration resolves the condition. Whether small amounts of alcohol helps promote cardiac health or not- it is habit forming and alcoholism is a root cause for ill health along with social consequences.

Competing interests: No competing interests

26 March 2017
dhastagir Sheriff
Professor
Melmaruvathur Adhiparasakthi Institute of Medical Sciences and Research
Melmaruvathur