Alcoholic cardiomyopathyDefinition: Alcoholic cardiomyopathy is a disorder in which excessive, habitual use of alcohol weakens the heart muscle. The heart cannot pump blood efficiently, and this in turn affects the lungs, liver, brain, and other body systems.
Alternative Names: Cardiomyopathy - alcoholic
Causes, incidence, and risk factors: Drinking alcohol in large quantities has a directly toxic effect on heart muscle cells. Alcoholic cardiomyopathy is a form of dilated cardiomyopathy caused by habitual alcohol abuse. Alcoholic cardiomyopathy causes the weakened heart muscle to pump inefficiently, leading to heart failure. In severe cases, the lack of blood flow affects all parts of the body, damaging multiple tissues and organs. The disorder is most commonly seen in males ages 35-55 years old, but it may develop in anyone who consumes too much alcohol over a long period of time. Alcoholic cardiomyopathy may be identified as "idiopathic dilated cardiomyopathy" if the person's drinking history is not known.
Symptoms: Symptoms are usually absent until the disease is in an advanced stage. At that point, the symptoms occur because of heart failure. Possible symptoms include:
Signs and tests: A health care provider will conduct a physical examination, which may reveal: Alcoholic cardiomyopathy is usually diagnosed when chronic heavy drinking is discovered as a cause of the heart failure. The following tests may reveal signs of heart failure: - An echocardiogram may show enlarged heart chambers, leaking valves, or reduced pumping efficiency.
- An ECG may show signs of enlarged heart chambers or rhythm abnormalities (arrhythmias).
- A chest x-ray or chest CT may show heart enlargement, fluid accumulation in the lungs and valves, and reduced pumping function.
- A complete routine laboratory study is performed to measure the hormone B-type natriuretic peptide (BNP).
- Cardiac catheterization and coronary angiography may be done to rule out coronary artery blockages as the cause for dilated heart chambers and decreased pumping function.
Treatment: You may be placed on a low-salt diet. The amount of fluids you drink may be restricted. Heart failure may be treated with diuretics (furosemide and spironolactone) to remove excessive fluid from your body, ACE inhibitors, and beta blockers. People with congestive heart failure and severely weakened pumping functions may receive an implantable defibrillator (ICD) to help them live longer. In some cases, a biventricular pacemaker improves the symptoms and quality of life. A single device that combines a biventricular pacemaker and an ICD may be recommended. A heart transplant may be considered when the cardiomyopathy is not reversible. Eventually, nutritional problems involving thiamine, phosphorus, potassium, or magnesium levels may require treatment.
Expectations (prognosis): Total abstinence from alcohol may stop the disease and improve the heart's functioning, although people with severe heart damage may not return to normal. Once the heart damage and heart failure is irreversible, the outlook is poor.
Complications: - Congestive heart failure
- Heart arrhythmias, including lethal arrhythmias
Calling your health care provider: Call your provider if you have any symptoms of heart failure or cardiomyopathy. Call your provider if alcoholic cardiomyopathy has been diagnosed and symptoms do not improve with treatment. Go to the emergency room or call 911 if severe chest pain, palpitations, or fainting occur in a person with alcoholic cardiomyopathy.
Prevention: Alcoholic cardiomyopathy is a consequence of years of excessive alcohol use. Do not use alcohol in excess. If you drink heavily and find that you cannot cut down or stop drinking, seek help. Control other risk factors for heart disease by maintaining a healthy weight and exercising regularly. Eat a generally well-balanced, nutritious diet and avoid or minimize smoking.
| 
