Alcoholic cardiomyopathy SpringerLink

Continued heavy alcohol use, on the other hand, will continue to make alcoholic cardiomyopathy worse. Caution for anticoagulation is warranted due to the problems of noncompliance, trauma, and overdosage especially in hepatic dysfunction. Although the severity of histological alterations on endomyocardial biopsy correlates with the degree of heart failure in one of our studies, biopsy is not in common use for prognostic purposes [117]. Even the recovery after abstinence of alcohol is hard to predict based on morphometric evaluation of endomyocardial biopsies [118].

  • The toxicity of alcohol damages and weakens the heart muscle over time.
  • The efficacy of abstinence has been shown in persons with early disease (eg, prior to the onset of severe myocardial fibrosis) and in individuals with more advanced disease (see Prognosis).
  • In some cases, especially those that are more severe, heart failure symptoms and related conditions may develop or get worse.
  • However, even reducing your drinking to light or moderate levels is better than continuing to drink heavily.
  • As early as in 1915, Lian [45] reported in middle-aged French servicemen during the first world war that heavy drinking could lead to hypertension.

Cardiomyopathy is a heart muscle disease that occurs when the heart muscle is thicker or stiffer than it is supposed to be. Cardiomyopathy that has developed as a result of chronic alcohol use is known as alcoholic cardiomyopathy (ACM). But heavy drinking can affect how well the liver can make proteins that help control blood clotting. That’s the main way drinking can interfere with medications commonly taken by people with heart failure — specifically certain blood thinners, Brown and Mukamal say. Alcoholic cardiomyopathy is a type of heart disease caused by long-term excessive alcohol consumption, leading to weakening and enlargement of the heart muscle, which impairs its ability to pump blood efficiently.

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However, consistent heavy drinking strains those protective processes — especially in your liver — making them less effective. Ultimately, your body can’t keep up with the damage to multiple organ systems, including your heart. The outlook for people with alcoholic cardiomyopathy varies depending on how long alcohol was abused and how much alcohol was consumed during that time. In cases where the damage to the heart is severe, the chances of complete recovery are low. Once the damage is considered irreversible, it’s difficult for the heart and rest of the body to recover.

Is alcoholic cardiomyopathy reversible?

In many — if not most — cases, abstaining from alcohol can be enough to help people recover from alcohol-induced cardiomyopathy.

Many medications can help in cases of alcohol-induced cardiomyopathy, treating the symptoms that happen because of this condition. Medications typically include beta-blockers (for heart rhythm and blood pressure issues) and diuretics (to help your body get rid of excess fluid and swelling). Treatment for this condition starts with helping you reduce your alcohol intake or stop drinking entirely. That also may involve supportive care that will help prevent — or at least reduce the impact of — any alcohol withdrawal symptoms. Supportive care for withdrawal is especially important because some of its symptoms can be severe or even life-threatening.


Your doctor will also ask you about your medical history and drinking habits. It’s important to be honest with your doctor about the extent of your alcohol use, including the number and amount of drinks you have each day. This will make it easier for them to make a diagnosis and develop a treatment plan. Positive outcomes for treating health consequences of alcoholic cardiomyopathy typically grow worse the longer a person has been drinking. The amount a person drinks and other factors can also affect how a person responds to treatment.

The postulated mechanism includes mitochondria damage, oxidative stress injury, apoptosis, modification of actin and myosin structure, and alteration of calcium homeostasis. Alcohol consumption causes an increase in mitochondrial fragmentation. Studies have shown an increase in reactive oxygen species (ROS) level in myocytes following alcohol consumption and thus causes oxidation of lipids, proteins, and DNA leading to cardiac dysfunction.

Diagnostic imaging

In 1893, Graham Steell, well known for the Graham Steell murmur due to pulmonary regurgitation in pulmonary hypertension or in mitral stenosis, reported 25 cases in whom he recognized alcoholism as one of the causes of muscle failure of the heart. In his 1906 textbook The Study of the Pulse, William MacKenzie described cases of heart failure attributed to alcohol and first used the term “alcoholic heart disease” [26]. Also ventricular arrhythmias have been described as an effect of intensified ingestion of alcohol and in (Singer and Lundberg, 1972; Greenspon and Schaal, 1983). Ventricular arrhythmia can range from increased ventricular ectopic activity, ventricular tachycardia to ventricular fibrillation. Several mechanisms have been discussed as pathophysiological basis for these arrhythmias in alcoholic patients. Electrographic measurements have demonstrated that a variety of abnormalities may underlie this propensity to arrhythmia.

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