SummaryShoshin beriberi is the fulminant form of beriberi heart disease, due to acute thiamine deficiency.In this report, we describe the case of a 34-ycar-old malnourished alcoholic man, who was studied in the acute phase of shoshin beriberi, with high-output cardiac failure, loss of Peripheral vascular resistance and severe Metabolic acidosis.Pathogenesis and possible mechanisms of this very rare complication of chronicalcoholism are reviewed.