Alcoholic Cardiomyopathy: Causes, Symptoms, and Diagnosis

Similarly, people with pre-existing heart conditions, such as coronary artery disease, are more vulnerable to alcohol’s effects on the heart muscle. The signs and symptoms of alcoholic cardiomyopathy (ACM) Sober living house can vary depending on the severity of the condition.6 In the early stages, people with ACM may not experience any symptoms. However, as the condition progresses, they may experience symptoms such as fatigue, shortness of breath, palpitations, and swelling of the legs and ankles.6 They may also experience chest pain, dizziness, and fainting. In some cases, ACM can cause arrhythmias or irregular heartbeats, which can be life-threatening.

Patient History

The diagnosis of ACM is usually one of exclusion in a patient with DCM with no identified cause and a long history of heavy alcohol abuse. According to most studies, the alcohol consumption required to establish a diagnosis of ACM is over 80 g per day during at least 5 years9-12. Alcohol causes cardiomyopathy by directly damaging heart muscle cells, impairing their function. Prolonged alcohol abuse weakens the heart muscle, leading to enlargement of the heart chambers, reduced pumping ability, and, ultimately, heart failure.

AMOUNT OF ALCOHOL REQUIRED TO PRODUCE ACM

8 Other investigators have looked at immunohistologic markers and have suggested that the presence of these markers might suggest an inflammatory process such as myocarditis and that their absence may point more toward AC or an idiopathic etiology. A 12-month observational study of 20 patients with AC noted smaller cavity diameters, better clinical evaluation findings, and fewer hospitalizations in the 10 patients who abstained from alcohol use. Furthermore, there are conflicting data among studies regarding the prognosis of the condition, with some showing overall mortality near 60% and others showing a mortality rate of only 19% (Table 1).

• There are no specific targeted histological or immunological biomarkers for the diagnosis of alcohol-induced cardiomyopathy.
• The key to diagnosis is a personal history of chronic heavy alcohol use and the absence of other etiologies.
• Among patients who continued drinking heavily, transplant-free survival was significantly worse than in non-drinkers (27% vs 45%).
• In the 16th century Paracelsus Theophrastus Bombastus from Hohenheim used this term for distilled liquor and called it alcohol 15.
• In fact, Brandt et al.54 observed that in ALDH2-deficient mice, the most important increase in mitochondrial superoxide levels (which is the major species of ROS) is due to acetaldehyde, not ethanol.
• The heart’s LV attempts to compensate for this damage by enlarging to achieve a higher blood output.
• It also appears that the changes emerging in ACM patients only differ from idiopathic DCM in quantitative terms, with histological changes being more striking in idiopathic DCM than in ACM44.

Lifestyle Quizzes

Blood tests for liver damage or other signs of chronic alcohol use can help confirm alcoholic cardiomyopathy as the cause of heart failure. However, myocarditis is often preceded by viral infections or flu-like symptoms, such as fever, body aches, or sore throat, which are not typical of alcoholic cardiomyopathy. Myocarditis can also cause chest pain that mimics a heart attack, which is less common in alcoholic cardiomyopathy.

In these studies, the authors estimated the amount and chronicity of alcohol intake and subsequently related the figures to a number of echocardiographic measurements and parameters. Although all of the studies reported an increase in left ventricular mass and volume, it cannot generally be stated that they provided the alcohol consumption dosage required to cause ACM. The pathophysiology of AC involves a combination of direct toxic effects of alcohol on the myocardium, oxidative stress, mitochondrial dysfunction, and genetic susceptibility. Dizziness is reported in about 20-30% of patients with alcoholic cardiomyopathy. It can occur when the heart is unable to pump enough blood to the brain, leading to lightheadedness or a sensation of spinning. Dizziness may also be related to arrhythmias or low blood pressure, both common in patients with weakened heart function.

Symptoms include gradual onset worsening shortness of breath, orthopnea/paroxysmal nocturnal dyspnea. Palpitations https://ecosoberhouse.com/ and syncopal episodes can occur due to tachyarrhythmias seen in alcoholic cardiomyopathy. 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. It took almost 60 years before further attention was paid to the complex interaction between the heart and the peripheral vasculature in various cross-sectional and prospective epidemiologic studies, which have empirically confirmed this early report.

• Pharmacologic therapy should include goal-directed heart failure therapy as used in idiopathic dilated cardiomyopathy with reduced ejection fraction.
• The first and most important diagnosis to rule out is coronary artery disease.
• These patients may also benefit from a dietary consult to assess nutrition.
• Due to its significant toxicity, studies have avoided its direct instillation, as it produces indiscriminate cell damage even at low doses.

Epidemiological studies

• Emmanuel Rubin analysed muscle biopsies from individuals who were previously non-drinkers and were submitted to a balanced diet with heavy alcohol intake during one month41.
• Yet, addressing alcohol use disorder is imperative to prevent further systemic damage and promote overall health.
• This condition is a sign of advanced heart failure and should be taken seriously.
• Alcoholic cardiomyopathy (ACM) is a heart disease that occurs due to chronic alcohol consumption.
• Alcoholic cardiomyopathy is a form of dilated cardiomyopathy, where the heart’s chambers enlarge and weaken due to alcohol’s toxic effects on the heart muscle.

A doctor can guide someone to resources to help them quit drinking and can make referrals. The NIAAA provides an Alcohol Treatment Navigator, where people can learn about AUD treatments and access care and support networks locally. Electrolyte abnormalities, including hypokalemia, hypomagnesemia, and hypophosphatemia, should be corrected promptly because of the risk of arrhythmia and sudden death. Chest radiographs usually show evidence of cardiac enlargement, pulmonary congestion, and pleural effusions. Not all treatments or services described are covered benefits for Kaiser Permanente members what is alcoholic cardiomyopathy or offered as services by Kaiser Permanente. For a list of covered benefits, please refer to your Evidence of Coverage or Summary Plan Description.