The Electrocardiogram in Pellagra.

Deficiency in thiamin, a factor of the vitamin B complex, may cause severe circulatory insufficiency. It is, therefore, of interest to study the circulation in another type of B-avitaminosis-pellagra. The circulatory disturbances encountered in pellagra are of no great clinical significance. Frequently low arterial pressure and tachycardia are present. CEdema, if there is any, can scarcely be attributed to circulatory insufficiency, even if exclusively present at the lower extremities. As shown by the example of beri-beri and the famine aedema, this accumulation of fluid is especially connected with changes of the tissue itself and the composition of the plasma. For these reasons it is particularly the electrocardiogram that is dealt with in this paper. As far as we know only Porter (1934) and Feil (1936) have studied this question. The former found nothing more than sinus tachycardia; the latter, who investigated 38 pellagra patients, found in 14 of them electrocardiographic changes that could not be attributed to other circulatory disturbances. There was sinus tachycardia, low voltage of the ventricular complex, a high T, a Pardee-type of T, an abnormals hape of the S-T portion, as well as a negative T wave. In the chest lead also some abnormalities were found, e.g. low voltage, M-shape of the ventricular complex, a monophasic S-T, or an upright T. The changes in the electrocardiogram gradually disappeared, in part, when the pellagra itself was cured, thus revealing their relationship with the disease.