Alcoholic Cardiomyopathy: Causes, Symptoms, and Diagnosis

Once free from alcohol, substance abuse treatment and medical treatments for alcoholic cardiomyopathy can begin. The possibility of recovery from alcoholic cardiomyopathy depends primarily on the level of damage to the heart. Imaging tests might also be ordered as well, such as chest x-rays, echocardiographic scans, or CT scans. These can reveal an enlarged heart, irregular heartbeats (arrhythmias), fluid accumulation, unstable ejection fraction, and leaking valves.

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These changes are related to both direct alcohol toxicity on cardiac cells and the indirect toxicity of major alcohol metabolites such as acetaldehyde. Chronic alcohol consumption can cause multi-organ damage including myocardial dysfunction. There are no specific targeted histological or immunological biomarkers for the diagnosis of alcohol-induced cardiomyopathy. 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. “Chronic alcohol consumption can also contribute to high blood pressure and heart rhythm issues, and that puts strain on the heart muscle in a way that may lead to cardiomyopathy,” Segal says. “If damage is not yet severe, there’s a chance that you can recover and get back heart function to a large extent.”

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• This fact has been assessed with echocardiographic monitoring in women consuming high doses of ethanol both in the subclinical period of disease 46 as well as in the clinical period when congestive heart failure appears 95.
• The suspicion that there may be an individual susceptibility to this disease is underscored by the finding that only a small group of alcoholics develop ACM, and that a proportional relationship between myocardial damage and alcohol intake has not been proven.
• Therefore, efforts for the prevention, early detection, and specific treatment in this relevant disease should be established 45.
• However, ischemic heart disease often causes chest pain during physical activity or stress (angina), which is less common in alcoholic cardiomyopathy.
• Some of these papers have also described the recovery of LVEF in many subjects after a period of alcohol withdrawal15-17.

Cardiovascular disease is an umbrella term for many different conditions affecting heart function—including diseases of the valves or vessels—while cardiomyopathy affects the heart muscle specifically. With this condition, the muscle can weaken, stiffen, or become inflamed, making it more difficult for your heart to pump blood effectively. Although some studies have detailed structural and functional damage in proportion to the amount of alcohol consumed during a patient’s lifetime24, a large majority of authors have discarded this theory21-23,25.

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Unfortunately, alcoholic cardiomyopathy does not typically present with progressive symptoms. However, cardiac apoptosis may also develop independently of the mitochondrial pathway 115 through the extrinsic pathway, which involves cell surface death receptors 116. In addition to inducing apoptosis, ethanol inhibits the effect what is alcoholic cardiomyopathy of anti-apoptotic molecules such as BCL-2 101. Ethanol-induced myocyte apoptosis may be regulated by growth factors 117,118 and cardiomyokines 119.

• The first paper to assess the natural history and long-term prognosis of ACM was published by McDonald et al69 in 1971.
• The effects of alcohol-induced cardiomyopathy may be lifelong for most chronic cases.
• 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.
• Left ventricular function can improve within six months, with complete recovery within 18 months.

For more resources on dealing with substance abuse, visit our article on character defects. Abnormal heart sounds, murmurs, ECG abnormalities, and enlarged heart on chest x-ray may lead to the diagnosis. Pharmacologic therapy should include goal-directed heart failure therapy as used in idiopathic dilated cardiomyopathy with reduced ejection fraction. This includes a combination of beta-blockers, an angiotensin-converting enzyme inhibitor, diuretics, aldosterone receptor antagonist and angiotensin blocker-neprilysin inhibitor (if LVEF is less than or equal to 40%). The use of carvedilol, trimetazidine with other conventional heart failure drugs have been proven to be beneficial in some studies.

Future https://ecosoberhouse.com/ studies in ACM should also address this topic, which has important economic consequences. Experimental studies analysing the depressive properties of alcohol on the cardiac muscle invariably use similar approaches31-39. 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 frequency31.

Alcoholic Cardiomyopathy: Causes, Symptoms, and Treatment Options

If you feel that any of our content is inaccurate, out-of-date, or otherwise questionable, please contact at All Addiction Resource content is medically reviewed or fact checked to ensure as much factual accuracy as possible. Alcoholic cardiomyopathy is best managed with an interprofessional approach with the involvement of primary care physician and cardiology.

Virtual consultations allow you to receive personalized care, discuss symptoms, and adjust treatments without in-person visits, especially beneficial for those with mobility issues or living in remote areas. Patients may experience improved heart function and reduced fatigue and shortness of breath within a few weeks, though careful monitoring is needed to avoid toxicity. Patients may notice improved heart function and reduced swelling within a few weeks, though regular blood tests are required alcoholism symptoms to monitor potassium levels and kidney function.

Alcoholism & Cardiovascular Issues

In conditions of acute alcohol toxicity, ethanol has been shown to increase circulating catecholamine, which may play a role in myocardial damage. It can also lead to dehydration and raised blood pressure, which contributes to an elevated heart rate. While a moderate increase is usually temporary, chronic heavy drinking or binge drinking can cause more serious cardiovascular issues, such as arrhythmias and high blood pressure.

According to the NIAAA, many people with AUD recover, although setbacks are common among those receiving treatment. 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. This can cause heart inflammation, leading to an atypically fast heart rhythm, such as atrial fibrillation (AF). As a point of reference, consuming 80 grams of alcohol daily for at least 5 years can significantly increase the risk of ACM.