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Received March 2, 2010; revised manuscript received April 20, 2010; accepted May 9, 2010; released online July 6, 2010 Time for primary review: 29 days Cardiovascular Division, Institute of Clinical Medicine, Graduate School of Comprehensive Human Sciences, University of Tsukuba, Tsukuba, Japan Mailing address: Hiroshi Tada, MD, Cardiovascular Division, Institute of Clinical Medicine, Graduate School of Comprehensive Human Sciences, University of Tsukuba, 1-1-1 Tennodai, Tsukuba 305-8575, Japan. E-mail: htada@md.tsukuba.ac.jp ISSN-1346-9843 doi: 10.1253/circj.CJ-10-0202 All rights are reserved to the Japanese Circulation Society. For permissions, please e-mail: cj@j-circ.or.jp Reversible Pulmonary Hypertension, Lactic Acidosis, and Rapidly Evolving Multiple Organ Failure as Manifestations of Shoshin Beriberi