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Help for Alcoholic Cardiomyopathy

Chronic alcohol abuse can cause an enlarged heart, which may cause other problems, such as high blood pressure, damage to other organs and sudden death. (See Reference 1) It is the direct toxic effect of ethanol (alcohol) on the heart that produces alcoholic cardiomyopathy. Although women are more vulnerable to the disease, its incidence in men is higher because of men's greater tendency to abuse alcohol.

  1. What is cardiomyopathy?

    • Alcoholic cardiomyopathy (enlarged heart) results from long-term abuse of alcohol, which has a directly toxic effect on the heart. The heart muscle becomes enlarged and thinner, with the result that the heart can not pump blood all over the body as effectively. The amount of blood pumped (ejection fraction) decreases as the disease progresses.

      If not arrested, alcoholic cardiomyopathy, with its reduced flow of blood, can damage many other tissues and organs. The process of heart degeneration with impaired pumping is called heart failure. The condition is most prevalent in men 35 to 55 years old; often, there are no symptoms until the disease reaches advanced stages.

      Chronic abuse of alcohol is also a factor in cardiac arrhythmias (irregular heartbeat) such as atrial flutter and fibrillation, premature heart contractions, hypertension (high blood pressure), stroke and death.

    What are the symptoms?

    • Symptoms of cardiomyopathy include palpitations, dizziness, fainting, swelling of lower extremities, nighttime awakening with shortness of breath, difficulty breathing while lying down, fatigue, weakness, cough that produces pink and frothy mucus, diminished alertness, decreased urine production, irregular pulse, loss of appetite and increased urination at night. (See Reference 2)

    How is it diagnosed?

    • Heart failure is diagnosed using several tests, including an echocardiogram, which shows enlarged heart chambers and/or impaired pumping capacity; an electrocardiogram (ECG), which can show enlargement and abnormal heart rhythms; cardiac catheterization or angiography, which can help rule out coronary occlusions (blockages); and a chest X-ray or CT scan, which can reveal enlarged heart, fluid buildup and impaired ejection fraction.

      A complete history and physical exam, with particular attention to alcohol abuse, and laboratory blood tests can further help diagnose the disease.

    What are the treatments?

    • Treatment for alcoholic cardiomyopathy may begin with restriction to a low-sodium diet, as well as a strong recommendation that the patient stop drinking completely and referral to treatment centers and support groups, such as AA.

      Alcoholic heart failure also may be treated with ACE (angiotensin converting enzyme) inhibitors, beta blockers and diuretics that increase urine output. A heart pacemaker can improve symptoms and quality of life, and when the cardiomyopathy is not reversible, a heart transplant may be an option. In addition, nutritional analysis and adjustment is often required.

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