Guillo et al17 in 1997 described the evolution of 9 ACM patients who had been admitted. He divided this cohort into two groups according to the evolution of the ejection fraction during 36 mo in which no deaths were recorded. The 6 subjects who experienced a clear improvement in their ejection fraction had fully refrained from drinking. Conversely, the 3 subjects recording a less satisfactory evolution had persisted in their consumption of alcohol. It should be noted that a moderate drinker included in this latter group showed an improvement of his ejection fraction. Although some studies have detailed structural and functional damage in proportion to the amount of alcohol consumed during a patient’s lifetime24, a large majority of authors have discarded this theory21-23,25.

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People with alcoholic cardiomyopathy often have a history of heavy, long-term drinking, usually between five and 15 years. Heavy drinking is alcohol consumption that exceeds the recommended daily limits. To diagnose alcoholic cardiomyopathy, your doctor will conduct a physical exam and ask about your medical history. The physical test will involve simple tests to identify signs of alcoholic cardiomyopathy or congestive heart failure. The short answer to what causes alcoholic cardiomyopathy is heavy and typically chronic alcohol use.

In this review, we evaluate the available evidence linking alcohol consumption with HF and DCM. We also discuss the clinical presentation, prognosis and treatment of ACM. Anyone with concerns about alcohol consumption or heart health needs to consult a doctor for further advice and guidance. Often, when a doctor suspects cardiomyopathy, they will order an echocardiogram. This test will assess the ejection fraction (EF), a measurement that expresses how much blood the LV pumps out with each contraction.

Alcohol-induced cardiomyopathy is a condition where your heart changes shape because of long-term heavy alcohol use. The changes to your heart’s shape cause long-term damage, leading to heart failure and severe problems. Abstaining from alcohol may help some people recover, but others will need medication or even surgery. Call your doctor right away if you think you have alcoholic cardiomyopathy. Prompt treatment can help prevent the disease from getting worse and developing into a more serious condition, such as congestive heart failure (CHF). Alcoholic cardiomyopathy is a condition that weakens your heart and its ability to pump blood.

• The continuous loss of heart muscle cells along with the inflammatory responses and oxidative stress can potentially lead to enlargement of the heart chambers, particularly the left ventricle.
• In that case, patients may need a pacemaker to stabilize their heart rhythm, surgery to repair the valves, or even a heart transplant to truly recover.
• In advanced cases of heart failure, devices like implantable cardioverter defibrillators (ICDs) or cardiac resynchronization therapy devices may be implanted to regulate heart rhythms and improve cardiac performance.
• Myocardial impairment following chronic excessive alcohol intake has been evaluated using echocardiographic and haemodynamic measurements in a significant number of reports.
• The NIAAA provides an Alcohol Treatment Navigator, where people can learn about AUD treatments and access care and support networks locally.
• If left untreated, alcoholic cardiomyopathy can lead to long-term health complications and death.

He recruited 48 patients admitted to hospital with cardiomegaly without a clear aetiology and severe alcoholism. The only factor to predict a poor alcoholism symptoms outcome was the duration of symptoms before admission. While cardiomyopathy can have many potential causes, alcoholic cardiomyopathy is unique because it can be directly affected by the patient’s behavior. It is both caused by excessive alcohol use and can be treated by cutting out alcohol use. While its causes can range from family-inherited genes to viral infections and high blood pressure, excessive alcohol use is also among them.

Diagnosis and Tests

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• According to clinical research, most of the symptoms of alcoholic-induced cardiomyopathy occur when the disease is irreversible and advanced and may start with signs of congestive heart failure.
• “This effect has even been referred to as ‘holiday heart syndrome,’ for people who don’t usually drink much may experience it with friends or family over a holiday,” Dr. Sarraju shares.
• Poor circulation from an underactive heart can result in fluid accumulation in the lungs, known as pulmonary edema.
• They may also use diuretics to help your body remove excess fluid and reduce swelling.

Long-term alcohol abuse and excessive drinking can come with far more dangers than addiction. While some of the potential diseases that result from it may be rare, they can become serious quickly–especially when they involve a patient’s heart. Without full abstinence, the 4-year mortality rate for ACM can be as high as 50% and ACM is a common cause of death among long-term heavy drinkers. The best approach to treat alcohol-induced cardiomyopathy is addressing the source of the disease. Complete abstinence from alcohol is crucial to prevent further damage to the heart muscle.

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• ACM weakens the heart’s ability to pump blood effectively, leading to heart failure.
• The effect is much like how a rubber band or spring weakens when stretched too much.
• They found that 2 of the 6 individuals (33%) whose alcohol consumption exceeded 125 mL/d had cardiomegaly.
• Many medications can help in cases of alcohol-induced cardiomyopathy, treating the symptoms that happen because of this condition.

In this respect, a higher prevalence of excessive alcohol consumption has been reported among individuals diagnosed with DCM than in the general population8. Since those initial descriptions, reports on several isolated cases or in small series of patients with HF due to DCM and high alcohol intake have been published15-17. Some of these papers have also described the recovery of LVEF in many subjects after a period of alcohol withdrawal15-17. Alcoholic cardiomyopathy is a chronic problem, eventually leading to heart failure. There are no specific lab tests to diagnose ACM, but some may be useful for checking the extent of alcohol-induced damage.

Management and Treatment

On occasion and in exceptional cases, cardiac muscle biopsies may be undertaken in order to directly examine a small tissue sample from the heart for signs of cardiomyopathy. Alcoholic cardiomyopathy primarily affects the heart and can have significant physical and mental impacts. Basic research studies have described an abundance of mechanisms that could underscore the functional and structural alterations found in ACM. Because of this, their origin could be multifactorial and linked both to the alcohol molecule and to its main metabolite, acetaldehyde. Furthermore, Fernández-Solá et al30, when analysing a population of alcoholics, found a higher prevalence of DCM in alcoholics than among the general population.

Additionally, echocardiographic data suggest that subjects who do not fully withdraw from alcohol consumption, but who reduce it to moderate amounts recover LVEF in a similar manner to strict non-drinkers. Thus, Nicolás et al73 studied the evolution of the ejection fraction in 55 patients with ACM according to their degree of withdrawal. The population was divided into 3 groups according to their intake volume during the follow-up period. At the end of the first year, no differences were found among the non-drinkers, who improved by 13.1%, and among those who reduced consumption to g/d (with an average improvement of 12.2%).

NATURAL HISTORY OF ALCOHOLIC CARDIOMYOPATHY

ACM is a type of heart disease that develops due to chronic alcohol consumption. As you reduce your alcohol intake, your provider will also treat your symptoms. This usually involves certain types of medications that treat heart rhythm problems or other symptoms of heart failure.

Experimental studies analysing the depressive properties of alcohol on the cardiac muscle invariably use similar approaches31-39. Accordingly, a given amount of alcohol is administered to volunteers or alcoholics, followed by the measurement of a number of haemodynamic parameters and, in some cases, echocardiographic parameters. Generally, following alcohol intake, healthy, non-drinking individuals showed an increase in cardiac output due to a decline in peripheral arterial resistance and an increase in cardiac frequency31. However, during the time that these haemodynamic changes appeared, some researchers identified a possible decrease in the ejection fraction and other parameters related to systolic function32-39. This was questioned by other authors, who pointed out that these conclusions could not be drawn, as alcohol itself also induces changes in the pre-load and after-load conditions, which influence cardiac contractility35.

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