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His documented signs and symptoms included inflamed gums attributed to scurvy, severe dyspnea, and exercise intolerance, presenting in a setting of nutritional deficiency. Physical examinations at a later date, also following a prolonged diet of limited fresh food, revealed a pulmonary systolic murmur. Thiamine deficiency with cardiomyopathy, either alone or subsequently exacerbated by advanced scurvy, may have been a prominent cause of Shackleton\u2019s condition.<\/jats:p>","DOI":"10.1177\/09677720211002205","type":"journal-article","created":{"date-parts":[[2021,4,24]],"date-time":"2021-04-24T03:14:48Z","timestamp":1619234088000},"page":"10-15","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":1,"title":["The signs and symptoms of Ernest Shackleton"],"prefix":"10.1177","volume":"31","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1909-5225","authenticated-orcid":false,"given":"PG","family":"Firth","sequence":"first","affiliation":[{"name":"Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, Boston, MA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"OJ","family":"Benavidez","sequence":"additional","affiliation":[{"name":"Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, Boston, MA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"L","family":"Fiechtner","sequence":"additional","affiliation":[{"name":"Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, Boston, MA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2021,4,24]]},"reference":[{"key":"bibr1-09677720211002205","volume-title":"Diary of the \u201cDiscovery\u201d expedition","author":"Wilson EA.","year":"1967","edition":"1"},{"key":"bibr2-09677720211002205","doi-asserted-by":"publisher","DOI":"10.5962\/bhl.title.61076"},{"key":"bibr3-09677720211002205","volume-title":"Shackleton's critic","author":"Marshall ES.","year":"2020","edition":"1"},{"key":"bibr4-09677720211002205","volume-title":"The life of Sir Ernest Shackleton","author":"Mill HR.","year":"1923","edition":"1"},{"key":"bibr5-09677720211002205","volume-title":"Shackleton","author":"Fisher M","year":"1957","edition":"1"},{"key":"bibr6-09677720211002205","unstructured":"Huntford R. 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