In patients with DC, if additional questions remain after a history is obtained and noninvasive testing is performed, cardiac catheterization may be used to help exclude other etiologies of heart failure. Frequently, a relative decrease occurs in systolic blood pressure because of reduced cardiac output and increased diastolic blood pressure due to peripheral vasoconstriction, resulting in a decrease in the pulse pressure. Physical examination findings in AC are not unique compared with findings in DC from other causes. Elevated systemic blood pressure may reflect excessive intake of alcohol but not AC per se. In severe cases where medical therapy fails, advanced interventions such as implantable cardioverter-defibrillators (ICDs), mechanical circulatory support devices, or heart transplantation may be considered.

Various pathophysiological mechanisms have been postulated in the development of cardiomyopathy however one key factor undergoing active research is the role of genetic mutation and susceptibility to develop cardiomyopathy. Furthermore, in many of these reports, comorbid conditions, especially myocarditis and other addictions alcoholic cardiomyopathy is especially dangerous because such as cocaine and nicotine, were not reported. Future studies with a strict classification of non-drinkers and drinkers will help clarify whether complete abstinence is mandatory for ACM patients. In the interim it seems appropriate to continue discouraging any alcohol consumption in these patients, as it would be difficult for them to maintain a limited alcohol intake considering their history of alcohol dependence and abuse.

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• A 1- and 4-year follow-up study of 55 men with alcoholism showed that abstinence and controlled drinking of up to 60 g/day (4 drinks) resulted in comparable improvement in LV ejection fraction.
• In a subsequent study using electron microscopy, the authors found histological features that could be superimposed onto those found in hearts that had suffered hypoxia, anoxia or ischemia43.
• 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.
• 11 Multiple case reports and small retrospective and prospective studies have clearly documented marked improvement in or, in some patients, normalization of cardiac function with abstinence.
• Additionally, the accepted ACM definition does not take into account a patient’s sex or body mass index (BMI).

Even in cases where people can undergo a heart transplant, individuals with a history of alcohol-induced cardiomyopathy are more likely to face other health problems down the road. 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.

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). Completely abstaining from alcohol is the key recommendation if you have alcohol-induced cardiomyopathy. Your healthcare provider will likely recommend that you also focus on improving your diet in ways that help your heart. This usually involves limiting your sodium (salt) and cholesterol intake and ensuring you are getting a diet that provides all essential nutrients. That’s because vitamin and mineral deficiencies are more common in individuals who are chronic heavy drinkers.

Medical records

The best way to reduce your risk of developing alcohol-induced cardiomyopathy is to only drink in moderation. That is especially true if you have any kind of condition that affects how your body processes alcohol. This condition tends to be worse the more you drink and/or the longer you were a heavy drinker. Other health problems you have can also affect your case, especially if those problems have any connection with alcohol use. While alcohol-induced cardiomyopathy comes from long-term alcohol abuse, there’s no universal limit or number that means you’ll develop it.

Conditions/Diagnoses

While some consider that this toxin alone is able to cause such a disease18,19, others contend that it is just a trigger or an agent favouring DCM3,21,22. Doctors may perform a right heart catheterization to measure pressure in the pulmonary arteries. Elevated pressures suggest pulmonary hypertension, while alcoholic cardiomyopathy would show a weakened heart muscle on an echocardiogram without elevated lung pressures. In valvular heart disease, it will show valve problems like narrowing or leaking, while in alcoholic cardiomyopathy, the heart valves Drug rehabilitation are usually unaffected, but the heart muscle is weakened. Doctors may perform a stress test to monitor your heart during exercise or a coronary angiogram to check for artery blockages.

In conclusion, a combination of lifestyle choices, medical conditions, and genetic factors can contribute to the development of alcoholic cardiomyopathy. Understanding these risk factors can help individuals make informed decisions about their health and seek early intervention if they are at risk. According to the American Heart Association, alcoholic cardiomyopathy accounts for approximately 3-40% of all dilated cardiomyopathy cases in Western countries. It is more common in men, but women are also at risk, especially with long-term alcohol abuse.

• For patients, understanding the full spectrum of alcohol’s effects may provide the motivation needed to seek help or support loved ones in doing so.
• Finally, only Urbano-Márquez et al24 found a clear decrease in the ejection fraction, in a cohort of 52 alcoholics, which was directly proportional to the accumulated alcohol intake throughout the patients’ lives.

These chambers are important as they do the majority of the work of your heart, with the right ventricle pumping blood to your lungs and the left ventricle pumping blood to your entire body. Weakening in the muscles around the ventricles means they can’t pump as hard, which negatively affects your entire body. Alcohol-related cardiomyopathy is a type of dilated cardiomyopathy, which is when your heart’s shape changes because its muscles are stretching too much. The effect is much like how a rubber band or spring weakens when stretched too much.

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Moreover, alcohol can interact with medications used to treat cardiovascular conditions, potentially reducing their effectiveness or causing dangerous side effects. It can also worsen other comorbidities such as diabetes, obesity, and liver disease, which further complicate cardiovascular care. Recognizing these interconnected risks highlights the importance of addressing alcohol abuse as a central component of heart health. One of the challenges in diagnosing alcoholic cardiomyopathy is that the condition often remains asymptomatic until it reaches an advanced stage. Early on, the heart may compensate for the loss of function, and patients may feel normal or experience only mild fatigue. In addition, people who receive early treatment for ACM, including medication and lifestyle modifications, have a better chance of improving their heart function and overall health.

Unfortunately, all the available reports were completed at a time when a majority of the current heart failure therapies were not available (Table 1). For many decades, ACM has been considered one of the main causes of left ventricular dysfunction in developed countries. Specifically in the United States, ACM was declared the leading cause of non-ischemic DCM7; a fact related to the high consumption of alcoholic beverages worldwide, which is particularly elevated in Western countries26 . Doctors will assess your alcohol use and perform tests like an echocardiogram to evaluate heart function. Blood tests for liver damage or other signs of chronic alcohol use can help confirm alcoholic cardiomyopathy as the cause of heart failure. Although the most common cause of heart failure is coronary artery disease, ischemic cardiomyopathy is unlikely in the absence of a clear history of prior ischemic events or angina and in the absence of Q waves on the ECG strip.

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If left unaddressed, alcoholic cardiomyopathy can progress to end-stage heart failure, marked by fluid overload, extreme fatigue, and severe exercise intolerance. Arrhythmias such as atrial fibrillation or ventricular tachycardia become more common, significantly increasing the risk of sudden cardiac death. The weakened heart can also lead to blood pooling and clot formation, raising the likelihood of stroke.