Beriberi, a clinical syndrome caused by thiamine deficiency, occurs in patients malnourished from alcohol use disorder, TPN without vitamin supplementation, or bariatric surgery. This case report describes a contemporary case of "wet" beriberi manifest as high-output heart failure. Shoshin beriberi (from the Japanese sho, meaning acute damage, and shin, meaning heart) is characterized by CV collapse and multiorgan failure. Conventional heart failure management may prove fatal. Learn more at http