Richardson et al showed an elevation of creatine kinase, LDH, malic dehydrogenase, and alpha-hydroxybutyric dehydrogenase levels in endomyocardial biopsy specimens taken from 38 patients with DC. Individuals who completely quit alcohol generally have improved overall outcomes. They typically require fewer hospitalizations and show improved heart function on ECG readings. Around 40–80% of people with ACM who continue drinking alcohol die within 10 years of their diagnosis. A 2023 article notes that ACM carries a more positive outlook than ischemic cardiomyopathy, which refers to heart damage that typically occurs due to CAD. As a point of reference, consuming 80 grams of alcohol daily for at least 5 years can significantly increase the risk of ACM.
Cardiac magnetic resonance
It’s important to note that alcoholic cardiomyopathy may not cause any symptoms until the disease is more advanced. The more severe the alcoholic cardiomyopathy, additional treatment options may be necessary. Blood pressure medications (such as ACE inhibitors or beta-blockers), a defibrillator, or pacemakers can be prescribed if the damage to the alcoholism heart is due to alcoholic cardiomyopathy. The doctor may also order a liver function test, to determine any liver damage, enzyme levels, check for liver disease (such as cirrhosis), as well as blood tests to check levels, including cholesterol. Unfortunately, alcoholic cardiomyopathy does not typically present with progressive symptoms. 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.
Study design:
- At ultrastructural level, dysfunction on the transition pore in the inner membrane is related to ethanol exposure 111.
- Some of these papers have also described the recovery of LVEF in many subjects after a period of alcohol withdrawal15-17.
- However, cardiac apoptosis may also develop independently of the mitochondrial pathway 115 through the extrinsic pathway, which involves cell surface death receptors 116.
- Once the 15 articles were selected (see Appendix Table 1 for the list of included articles), we extracted and organized relevant information from them.
- In the study by Gavazzi et al10, ACM patients who continued drinking exhibited worse transplant-free survival rates after 7 years than those who stopped drinking alcohol (27% vs 45%)10.
- However, nutritional factors may worsen the natural course of ACM and should be avoided 18,19.
Finally, it should be noted that McKenna and co-workers, in one of the most frequently cited papers in the ACM field, reported an incidence of 40% in 100 individuals suffering from idiopathic DCM, but in this case the consumption threshold used was only g/d8. At present ACM is considered a specific disease both by the European Society of Cardiology (ESC) and by the American Heart Association (AHA)18,19. In the ESC consensus document on the classification of cardiomyopathies, ACM is classified among the acquired forms of DCM19. Electrolyte abnormalities, including hypokalemia, hypomagnesemia, and hypophosphatemia, should be corrected promptly because of the risk of arrhythmia and sudden death.
Heartache in a Bottle: Understanding Alcoholic Cardiomyopathy
Therefore, complete abstinence from ethanol is the most useful measure to control the natural course of ACM 51,56,135. In fact, https://ecosoberhouse.com/ patients with ACM who abstain from alcohol have a better long-term prognosis than subjects with idiopathic dilated CMP 54. Out of end-stage cases, the majority of subjects affected by ACM who achieve complete ethanol abstinence functionally improve 33,82,135. The percentage of effective abstinence achievement on these patients submitted to specific programs ranges from 50% to 60% 8,9. Therefore, many ACM subjects are not able to effectively control their alcohol-consumption rates. Therefore, any decrease in the previous quantity of alcohol consumption may improve, to some degree, cardiac health 51.
NATURAL HISTORY OF ALCOHOLIC CARDIOMYOPATHY
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. Orthopnea, or difficulty breathing while lying flat, affects around 40-50% of patients with alcoholic cardiomyopathy. This symptom occurs because lying down causes fluid to shift from the lower extremities to the lungs, worsening pulmonary congestion. Patients with orthopnea often need what is alcoholic cardiomyopathy to sleep with their head elevated on pillows to alleviate symptoms.
5. The effects of Moderate Consumption of Ethanol and Binge-drinking
- New therapeutic strategies for AC are being developed with the support of animal models.
- 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.
- Ethanol induces ACM in a dose-dependent manner, independently of nutrition, vitamin, or electrolyte disturbances.
Indeed, the first account of the possible harmful effects of alcohol specifically on heart muscle was reported in the latter half of the 19th century. Expressions referring to “the heart of a wine drinker in Tubingen” and particularly a “Munich beer heart” were used and known in Germany during this time13. If left untreated, alcoholic cardiomyopathy can lead to long-term health complications and death. If you see any signs of alcoholic cardiomyopathy, contact emergency medical services immediately. Alcoholic cardiomyopathy is a condition that weakens your heart and its ability to pump blood. People who suffer from alcohol dependence or alcohol use disorder (AUD) are at risk of developing this condition.