Table 3: Selenium deficiency and cardiovascular abnormalities associated with other etiologies.

Causes of Selenium Deficiency	Patient Information	Gender/Age of Patient	Selenium Status (Normal Values)	Symptoms/Diagnostic Finding that Prompted Selenium Analysis	Administration Route	Length of Selenium Treatment that Resolves Symptoms	Ref
Parenteral Nutrition (PN)	PN was initiated for juvenile polyposis and three-months of refractory skin eruptions. Setting of PN was not reported. No selenium was added to PN. Patient received PN for 5 months	M 18 months	2 μg/dL (10.6-17.4ug/dL)	Xerotic skin changes with irregular shaped erythematous changes on cheek and Cardiomyopathy	Oral	100 μg/day for 24 days and then increased to 200 μg/day	[79]
Parenteral Nutrition	Reason for PN was not reported. Sixteen years on PN at home. Selenium was added to PN but the quantity was not reported.	M 28 years old	62 μg/L (80-230 ug/L)	Heart failure and ventricular premature beats	Not described	Not stated	[80]
Parenteral Nutrition	PN was initiated after ileostomy for nineteen days. Selenium was added to the PN at 32 μg/day.	M 27 years old	0.3 μmol/L (0.8-2umol/L)	Chest pain and tachycardia	Oral	100 μg/day for 3 months	[81]
Parenteral Nutrition	PN was initiated post right hemicolectomy for carcinoid tumor of the terminal ileum. PN administration setting not specified. Selenium was not added to the PN. Length of PN was not reported.	M 61 years old	110 μg/L (110-430 μg/L)	Worsening cardiac heart failure	Intravenous	40 μg/day for 25 days	[82]
Parenteral Nutrition	PN was initiated after ileostomy with resection of cecum and terminal ileum due to diagnosis of chronic idiopathic intestinal pseudoobstruction. PN was given at home. Selenium was not added to the PN. Patient had been on parenteral nutrition for 17 months	F 17 years old	<0.07μmol/L (reference values were not reported)	Incidental findings	Intravenous	100 μg/day for 35 days and then 200 μg/day for 6 months	[74]
Parenteral Nutrition	PN was given after first set of operations for small-bowel diverticulosis, incomplete rotation of colon and gastrojejunostomy ulcerations, cardiac symptoms. Setting of PN was not specified. Selenium was not added to the PN. Patient was on PN for 2 years.	M 43 years old	0.033 ng/mg hemoglobin (0.5-1 ng/mg hemoglobin)	Ventricular fibrillation, ventricular extra systole, non-sustained ventricular tachycardia, pulmonary edema, heart failure	Oral	Not described	[83]
Parenteral Nutrition	PN was initiated after intestinal resection of bowel after infarction, patient presented with cardiac symptoms. Patient was on PN for 5 months at home. Selenium was not added to the PN.	M 46 years old	Undetectable blood selenium level	Supraventricular tachycardia	Intravenous	150 μg/day for several weeks	[64]
Parenteral Nutrition	Reasons for PN were not reported. Patient received PN for 3 months. Selenium was not added to the PN	F 49 years old	50 mcg/L (55-130mc g/L)	Tender muscles of upper arms, buttocks, anterior and lateral thighs	Intravenous	200 mcg/day	[84]
Parenteral Nutrition	PN at home for 6 years because severe malnutrition secondary to vomiting and diarrhea. Selenium was not added to the PN.	M 24 years old	12 ng/ml (108 + 19 ng/ml)	Dyspnea and tachycardia	Not described	Not described	[85]
Parental Nutrition	PN was initiated because of malabsorption due to multiple bowel resection. Patient was on PN at home for 8 years. Selenium was not added to the PN.	M 42 years old	5-12% of normal	Chest pain and dyspnea	Not described	Not described	[86]
Malnutrition	Malnutrition due to total colectomy with end ileostomy from inflammatory bowel disease. Duration of malnutrition was unknown. Patient did not receive any PN prior to hospital presentation	F 53 years old	65 μg/L (80-230 μg/L)	Nausea, vomiting, epigastric pain, increased ileostomy output and tachycardia	Intravenous	100 μg/day for three weeks	[87]
Bariatric Surgery	Bilio-pancreatic diversion for weight loss resulting in severe protein deficiency. Patient presented 9 months post operation with cardiac symptoms	F 55 years old	<0.3 μmol/L (0.7-1.4μmol/L)	Dyspnea, weakness, chest tightness and tachycardia	Oral	Amount not reported, course of 3 weeks	[88]
Chylous Loss	Chylous loss secondary to bilateral chylothorax development post-surgical ablation of lymphangiomatosis, Patient presented with symptoms 10 years after first operation (whiles receiving PN). PN setting was not reported and PN duration was 10 years. Selenium was added at 5μg/kg.	M 11 years old	9.5 μg/L (55-150 μg/L)	Respiratory failure and hypotonia with leg weakness	Intravenous	110 μg/day for 8 days	[89]
Malnutrition	Malnutrition secondary to a diet consistent of only grits, sausage, beans, frankfurter, pork and Kool-Aid. Two years of malnutrition before onset of symptoms	F 2 years old	0.035 μg/ml (0.07-0.16 μg/ml)	Dyspnea and weakness	Oral	2 μg/day for 4 weeks	[90]
Chronic Diarrhea	Reason and duration for diarrhea not reported by authors.	M 15 months	9.1 μg/L (55-103 μg/L)	Labored breathing, tachypnea, weight loss and poor appetite	Intravenous	2 μg/kg/day for 3-4 months	[91]
Malnutrition	Reason for malnutrition not reported by authors. Two years of malnutrition before onset of cardiac symptoms	F 55 years old	38 μg/L (79-326 μg/L)	Dyspnea, weakness and repetitive syncope	Intravenous	100 μg/day for 3 weeks	[92]
Chronic Diarrhea	Diarrhea due to Crohn’s disease. Duration of diarrhea till cardiac symptom development was not reported.	F 22 years old	4 μg% (6-16 μg%)	Weight loss, malaise and tachycardia	Intravenous	200 μg/day for several weeks	[93]
Chronic Diarrhea	Diarrhea for a week due to C. Difficile colitis. Patient did not receive PN prior to hospital presentation	F 47 years old	0.34 μmol/L (0.75-1.5μmol/L)	Diarrhea	Intravenous	200 μg/day for 48 hours and then 100 μg/day for 10 days	[94]
Bariatric Surgery	Whipple for presumed carcinoma of pancreas (no histopathological confirmation). A Roux-en-Y gastric bypass procedure due to stricture of choledochojejunostomy. Post-surgical duration before symptoms appeared was not reported.	F 42 years old	0.7 μmol/L (0.9-2.0 μmol)/L)	Diarrhea and vomiting	Not described	Not applicable	[95]
Bariatric Surgery	Roux-en-Y bypass for medically complicated obesity. Patient presented with symptoms 4 years post the by-pass surgery	F 66 years old	41 ng/ml (95-165 ng/ml)	Weakness and poor oral intake	Oral	50 μg/day for 1 week	[96]
Bariatric Surgery	Roux-en-Y bypass to manage obesity. Patient presented with symptoms 9 months post the by-pass surgery.	F 40 years old	53 μg/L (89-150 μg/L)	Dyspnea and bilateral lower extremity pitting edema	Oral	2 μg/kg/day for 3 weeks	[97]
HIV	Patient presented with symptoms 2 years after HIV diagnosis	M 27 years old	24 μg/L (83 + 17 μg/L)	Tachycardia	Intravenous	Amount not reported	[98]
HIV	Patient infected by HIV via maternal birth and presented with cardiac symptoms after 6 years of life.	M 6 years old	29 μg/L (90-170 μg/L)	Tachycardia, Heart failure and respiratory distress	Oral	4 μg/kg/day for 3 weeks	[99]
RDEB	Patient was diagnosed with RDEB at 4 years old. At 6.3 years supplementary selenium (dose and form were not reported) was given for incidental low selenium of 0.53μmol/L. Patient remained deficient due to poor household conditions and 2 years later presented with dyspneic symptoms	M 6 years old	0.7 μmol/L (0.7-1.7 μmol/L)	Breathlessness and cough	Oral	Dose not reported; course of 4 months	[75]
RDEB	Patient was diagnosed with RDEB at 3.5 years, and presented with cardiac symptoms 8.5 years later	M 12 years old	0.7 μmol/L (0.7-1.7 μmol/L)	Breathlessness and cough	Oral	Dose not reported; course of 4 months	[75]
Cystic Fibrosis	Admitted to the hospital at 6.5 months for loose stools, edema and failure to thrive, and a diagnosis of cystic fibrosis was made at that time. Low selenium found during workup. Placed on parenteral nutrition. No information on selenium in the PN. After two weeks of hospital stay patient became tachypneic	M 6.5 months	5 μg/dL (10-20 μg/dL)	Tachypnea	Intravenous	100 μg/day for 3 weeks	[100]