Alcoholic Cardiomyopathy: Overview, Cardiac Effects of Alcohol, Quantity of Alcohol Intake in Cardiac Disease

Alcoholic Cardiomyopathy: Overview, Cardiac Effects of Alcohol, Quantity of Alcohol Intake in Cardiac Disease

If your heart is severely damaged, your doctor may recommend an implantable defibrillator or pacemaker to help your heart work. They commonly include fatigue, shortness of breath, and swelling of the legs and feet. To our knowledge, our study determined prognostic factors for ACM outcome in the largest cohort of ACM patients described to date.

  • However, given the characteristic rise and fall of cardiac enzyme levels, this supports the diagnosis of acute alcohol-induced myocardial damage.
  • The outlook for heart failure or cardiomyopathy depends on many factors, including the specific type of condition and its severity, as well as your age, your overall health, and what kind of treatment you’re receiving.
  • This review revisits our past and deals with our current thinking on the epidemiology, pathophysiology, clinical characteristics, and treatments available for alcoholic cardiomyopathy.
  • In the mid-1960s, another unexpected heart failure epidemic among chronic, heavy beer drinkers occurred in two cities in the USA, in Quebec, Canada, and in Belgium.
  • Medications may include ACE inhibitors, beta-blockers, and diuretics, which are commonly used to reduce the strain on the heart when treating cardiomyopathies.
  • This was interpreted by the authors as suggesting that acetaldehyde plays a key role in the cardiac dysfunction seen after alcohol intake.

Individuals who completely quit alcohol generally have improved overall outcomes. They typically require fewer hospitalizations and show improved heart function on ECG readings. For some people, a combination of factors could also lead to a weakened heart. Our patients tell us that the quality of their interactions, our attention to detail and the efficiency of their visits mean health care like they’ve never experienced. Let your health care provider know if you have a family history of the condition.

When to see a doctor

Various studies have shown that alcohol exerts a negative inotropic effect on the myocardium. It is possible that changes in calcium hemostasis may contribute toward this phenomenon, because this divalent cation plays an integral part in transmembrane ion movement and muscle contraction (9). Some have also suggested that lipid peroxidation may play a role in the pathogenesis of alcoholic cardiomyopathy (10). In conditions of acute alcohol toxicity, ethanol has been shown to increase circulating catecholamine, which may play a role in myocardial damage.

alcoholic cardiomyopathy life expectancy

Researchers have found thousands of genetic mutations that cause cardiomyopathies. Alcoholic cardiomyopathy is best managed with an interprofessional approach with the involvement of alcoholic cardiomyopathy primary care physician and cardiology. Other deficiencies including nutritional such as thiamine or other toxic materials ingested may lead to additional concomitant complications.


This inability occurs despite adverse effects on the person’s health, occupation, or relationships. Pharmacologic therapy should include goal-directed heart failure therapy as used in idiopathic dilated cardiomyopathy with reduced ejection fraction. This includes a combination of beta-blockers, an angiotensin-converting enzyme inhibitor, diuretics, aldosterone receptor antagonist and angiotensin blocker-neprilysin inhibitor (if LVEF is less than or equal to 40%). The use of carvedilol, trimetazidine with other conventional heart failure drugs have been proven to be beneficial in some studies. In patients exhibiting chronic alcohol use, other causes of dilated cardiomyopathy need workup. Investigative work up such as mean corpuscular volume (MCV), gamma-glutamyl-transpeptidase (GGT), elevated transaminases (AST, ALT) and elevated INR usually are seen in liver injury can be helpful as supportive evidence of alcohol use.[14][15].

  • Patient aims to help the world proactively manage its healthcare, supplying evidence-based information on a wide range of medical and health topics to patients and health professionals.
  • Atrial fibrillation and supraventricular tachyarrhythmias are common findings in 15–20 % of patients [111], whereas ventricular tachycardias are rare [112].
  • The authors conclude that their data show that this lethal condition is underdiagnosed and undertreated currently, emphasising the need for routine screening and interventions to reduce the alcohol-attributable mortality burden.
  • Some types of cardiomyopathy can be passed down through families (inherited).

Our experts continually monitor the health and wellness space, and we update our articles when new information becomes available. We do not receive any commission or fee that is dependent upon which treatment provider a caller chooses. Recovery is highly individualized and may or may not include medication-assisted treatment (MAT). For patient education information, see the Mental Health Center, as well as Alcoholism, Alcohol Intoxication, Drug Dependence and Abuse, and Substance Abuse.

Enlarged heart, in heart failure

A diagnosis of heart failure in an infant or child usually results from a congenital heart issue. Cardiomyopathy involves problems with your heart muscle that stem from an infection of heart tissue, overwork due to high blood pressure, or other causes. The muscle may thicken, become stretched, or contain unhealthy substances that affect its functioning.

Polyphenols of red barrique wines and flavonoids have been shown to inhibit endothelin-1 synthase [102] and PDGF-induced vasoproliferation thus also contributing to cardiovascular protection [103]. Clinical observation confirmed that several days to weeks of drinking show higher and weeks of abstinence lower pressures. Alcohol intake may also interfere with the drug and dietary treatment of hypertension. This altogether supports a causal relationship between alcohol consumption and a hypertensive state. Echocardiography is perhaps the most useful initial diagnostic tool in the evaluation of patients with heart failure. Because of the ease and speed of the test and its noninvasive nature, it is the study of choice in the initial and follow-up evaluation of most forms of cardiomyopathy.

Cardiac Catheterization

As a point of reference, consuming 80 grams of alcohol daily for at least 5 years can significantly increase the risk of ACM. Alcoholic cardiomyopathy is a leading cause of non-ischemic dilated cardiomyopathy in United States. In cardiomyopathy, the heart’s abnormal muscle can lead to an abnormal generation or propagation of electrical impulses. When undergoing an exam, it is important to be open and honest with your healthcare team. Being upfront about how much you drink and how often your drink can be crucial to the diagnosis.

The heart’s LV attempts to compensate for this damage by enlarging to achieve a higher blood output. However, as the LV enlarges, its muscular walls begin to thin and weaken. This eventually limits the heart’s ability to pump oxygen-rich blood around the body. Alcoholic cardiomyopathy is most common in men between the ages of 35 and 50, but the condition can affect women as well. People with alcoholic cardiomyopathy often have a history of heavy, long-term drinking, usually between five and 15 years.

Health Advice

While the two conditions are different in some ways, both are serious cardiac disorders that often require ongoing care to prevent potentially life threatening complications. An early diagnosis and proper treatment can sometimes restore heart muscle health. According to a 2022 review, about 15% of people with dilated cardiomyopathy experience a return to normal heart size and function with treatment.

  • This said, studies suggest that consuming over g of alcohol a day – the equivalent of 7 to 8 drinks – for more than five years substantially increases your risk of developing alcoholic cardiomyopathy.
  • Our study indicated that the QRS duration, systolic blood pressure, and New York Heart Association classification at admission provided independent prognostic information in patients with ACM.
  • Histologically, light microscopy reveals interstitial fibrosis (a finding that has been shown to be prevented by zinc supplementation in the mouse model), myocyte necrosis with hypertrophy of other myocytes, and evidence of inflammation.
  • We reviewed the effects of ethanol on the cardiovascular system in 1996 [15], including aspects of inflammation [16], rhythm disturbances [17], and hypertension [18].
  • Hypertrophic cardiomyopathy is a condition where the heart muscle walls are thickened.