Alcohol and Heart Health: Separating Fact from Fiction

In the ESC consensus document on the classification of cardiomyopathies, ACM is classified among the acquired forms of DCM[19]. 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. If a family member https://ecosoberhouse.com/article/alcoholics-heart-problems-cardiomyopathy/ has dilated cardiomyopathy, talk to your health care provider. In addition to the assessment of the status of the coronary arteries, cardiac catheterization may help obtain useful information regarding cardiac output, the degree of aortic or mitral valvular disease, and cardiac hemodynamics and filling pressures.

Excessive alcohol intake can lead to high blood pressure, heart failure or stroke. Excessive drinking can also contribute to cardiomyopathy, a disorder that affects the heart muscle. Regional wall motion abnormalities are not uncommon, but they are usually less prominent than those observed in persons with ischemic heart disease. 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 left ventricular (LV) ejection fraction. Ten patients who continued to drink higher amounts of alcohol all died during the follow-up period.

A single-center cohort study

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. Studies that have assessed the prevalence of ACM among IDCM patients have found high alcohol consumption in 3.8% to 47% of DCM patients. The lowest prevalence of ACM among DCM (3.8%) was obtained from a series of 673 patients admitted to hospital consecutively due to HF in the state of Maryland[27].

Overall, the risks of continued alcohol consumption outweigh this small benefit of this lipid improvement. The risk of atrial and ventricular dysrhythmias and sudden cardiac death are also increased in this population already prone to these adverse events [36, 37]. Consequently, alcohol consumption should be avoided in all patients with substantial heart failure and in those whose cardiomyopathy is suspected to be primarily from alcohol regardless of severity. Alcoholic cardiomyopathy (ACM) is a cardiac disease caused by chronic alcohol consumption.

1 Patients

Because hypertension may directly contribute to left ventricular (LV) dysfunction, this may be a confounding comorbidity in persons who abuse alcohol, and it should be differentiated from pure forms of alcoholic cardiomyopathy. Despite the key clinical importance of alcohol as a cause of DCM, relatively few studies have investigated the effects of alcohol on the heart and the clinical characteristics of DCM caused by excessive alcohol consumption (known as alcoholic cardiomyopathy). In summary, in preclinical alcohol-induced ventricular dysfunction, women are more sensitive to the toxic effects of ethanol than men. In overt alcoholic cardiomyopathy, women showed about the same prevalence of cardiomyopathy as men, despite having consumed far less ethanol.

What you should expect with this condition depends strongly on several factors. 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. In general, most people who stop drinking alcohol will feel better over the next three to six months. However, certain symptoms may start to improve even sooner, depending on treatments and the severity of your case.

Symptoms

When it can’t pump out enough blood, the heart starts to expand to hold the extra blood. Eventually, the heart muscle and blood vessels may stop functioning properly due to the damage and strain. Other findings may include cool extremities with decreased pulses and generalized cachexia, muscle atrophy, and weakness due to chronic heart failure and/or the direct effect of chronic alcohol consumption. Physical examination findings in alcoholic cardiomyopathy (AC) are not unique compared with findings in dilated cardiomyopathy from other causes.

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. Myocardial impairment following chronic excessive alcohol intake has been evaluated using echocardiographic and haemodynamic measurements in a significant number of reports. In these studies, haemodynamic and echocardiographic parameters were measured in individuals starting an alcohol withdrawal program. The findings were analysed taking into account the amount and chronicity of intake and they were compared with the same parameters measured in a control group of non-drinkers.

Your provider is the best source of information and guidance, and they can connect you to other resources that can help and experts who can assist. 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). The Centers for Disease Control and Prevention (CDC) defines heavy alcohol use — also known as heavy drinking — as more than eight drinks per week for women and more than 15 drinks per week for men. One drink is equal to 14 grams of pure alcohol, which can take many different forms because some forms have a higher concentration of alcohol than others. In patients exhibiting chronic alcohol use, other causes of dilated cardiomyopathy need workup.

Similarly, alcohol can have a toxic effect on your heart and cause scar tissue to form. That scar tissue can also cause potentially life-threatening arrhythmias (irregular heart rhythms). 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. Data suggests patients with successful quitting of alcohol have improved overall outcomes with a reduced number of inpatient admissions and improvement in diameter size on echocardiogram. Many changes can be observed including premature atrial or ventricular contractions, supraventricular tachycardias, atrioventricular blocks,  bundle branch blocks, QT prolongation, non-specific ST and T wave changes and abnormal Q waves.

What tests will be done to diagnose this condition?

Accordingly, a given amount of alcohol is administered to volunteers or alcoholics, followed by the measurement of a number of haemodynamic parameters and, in some cases, echocardiographic parameters. Generally, following alcohol intake, healthy, non-drinking individuals showed an increase in cardiac output due to a decline in peripheral arterial resistance and an increase in cardiac frequency[31]. 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 function[32-39]. This was questioned by other authors, who pointed out that these conclusions could not be drawn, as alcohol itself also induces changes in the pre-load and after-load conditions, which influence cardiac contractility[35]. However, in this context, experimental in vitro studies using cardiomyocytes have shown that alcohol depresses the contractile capacity of the myocardium, regardless of the sympathetic tone and the haemodynamic conditions[36]. However, in recent years interest in the relationship of alcoholic intake to the production of heart disease has increased considerably.

• A healthcare provider can also connect you with available resources and refer you to other specialists and experts who can help you reduce or stop your alcohol intake.
• 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).
• The mainstay of management is providing support, resources including but not limited to alcoholic anonymous and encouragement for alcohol abstinence and address underlying stressors if any which requires assistance from nursing staff and pharmacy.

He divided this cohort into two groups according to the evolution of the ejection fraction during 36 mo in which no deaths were recorded. The 6 subjects who experienced a clear improvement in their ejection fraction had fully refrained from drinking. Conversely, the 3 subjects recording a less satisfactory evolution had persisted in their consumption of alcohol.