Alcohol-Induced Cardiomyopathy: Causes, Symptoms and Treatment
On occasion and in exceptional cases, cardiac muscle biopsies may be undertaken in order to directly examine a small tissue sample from the heart for signs of cardiomyopathy. Under certain conditions, cardiac catheterization procedures may be performed to assess blood flow and pressures. https://ecosoberhouse.com/article/does-alcohol-dehydrate-you/ Because of the strain on the heart, its chambers can become enlarged, resulting in an overall stretching of the heart muscle. Certain populations are more vulnerable to ACM, such as middle-aged and older adults, as the risk of developing cardiac issues generally increases with age.
Natural history and prognosis of alcohol-induced cardiomyopathy
This is considered a last-resort treatment option only after other treatments have proven unsuccessful. If the individual continues drinking, treatment for ACM will be negated and further damage will occur. Exercise stress tests or functional assessments may be conducted to assess how your heart reacts during periods of physical exertion and alcoholic cardiomyopathy is especially dangerous because stress. This is most commonly seen in the legs, ankles and feet, but it can sometimes occur in the abdomen. Fluid retention can be significant, making a person look like they have gained weight suddenly despite a loss of appetite that generally accompanies ACM. Overall weakness and tiredness are common, even with minimal physical exertion.
Continuing Education Activity
If you notice any symptoms of alcoholic cardiomyopathy, seek immediate medical attention. This review revisits our past and deals with our current thinking on the epidemiology, pathophysiology, clinical characteristics, and treatments available for alcoholic cardiomyopathy. Those who engage in episodic or binge drinking (consuming a large amount of alcohol in a short period) over several years are at risk for ACM.
- Ethyl alcohol has detrimental effects on myocardial metabolism; nevertheless, the pathogenetic mechanisms of alcoholic cardiomyopathy remain uncertain.
- Mathews and Kino found a small, but significant increase in left ventricular mass in individuals consuming at least 12 oz of whisky during 6 years and 60 g of ethanol per day, respectively[22,40].
- The definition of heavy drinking is drinking more than 15 drinks per week in men or drinking more than eight drinks per week for women.
History and Physical
- This allows patients to reduce and stop their drinking in a safe and structured environment while receiving treatment for the core issues underlying their alcohol use.
- Genetic predisposition and individual susceptibility play a role in determining how alcohol affects an individual’s heart.
- Ten patients who continued to drink higher amounts of alcohol all died during the follow-up period.
- After a person with AUD completes a rehab program, they may need aftercare support.
- ACM weakens the heart’s ability to pump blood effectively, leading to heart failure.
- He recruited 48 patients admitted to hospital with cardiomegaly without a clear aetiology and severe alcoholism.
Markers for chronic alcohol consumption rely on liver enzymes such as gamma-glutamyltransferase (GGT) [119], glutamic oxalacetic transaminase (GOT), and glutamic pyruvic transaminase (GPT). Elevations of the transaminases (GOT, GPT), especially a ratio of GOT/GPT higher than 2 might be indicative of alcoholic liver disease instead of liver disease from other etiologies [120, 121]. An excellent marker is carbohydrate deficient transferrin (CDT), which best detects chronic alcohol consumption alone [122, 123] or in combination with the other markers such as GGT [8, 124]. Markers such as ethyl sulphate, phosphatidyl ethanol, and fatty acid ethyl esters are not routinely done.
Laboratory Studies
- Some studies have suggested that a genetic vulnerability exists to the myocardial effects of alcohol consumption.
- This heart dysfunction causes faints, shortness of breath, fluid retention, and overall decreased quality of life.
- In a subsequent study using electron microscopy, the authors found histological features that could be superimposed onto those found in hearts that had suffered hypoxia, anoxia or ischemia[43].
- It was characterized by congestive heart failure, pericardial effusion, and an elevated hemoglobin concentration.
- 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.
- The 6 subjects who experienced a clear improvement in their ejection fraction had fully refrained from drinking.
It is estimated, approximately 21-36% of all non-ischemic cardiomyopathies are attributed to alcohol. The prevalance of alcoholic cardiomyopathy in addiction units is estimated around %. Overall data with regards to alcohol induced cardiomyopathy is insuffienct and does not illustrate significant available data. Another nutritional factor classically involved in the pathophysiology of AC was cobalt excess.
What can I expect if I have this condition?
To maintain abstinence, recent investigations suggest the benefits of adjuvant medications, e. To treat the alcohol problem, a combined approach comprising pharmacologic and psychosocial therapy involving self-help groups or Alcoholics Anonymous is essential. The source was identified to be the filter of choice for wine and beer, i.e., diatomaceous earth [36]. The German word for it is Kieselguhr, a beige powder made up of the skeletons of diatoms. The trace amounts of arsenic have not been comparable to the arsenic-in-beer endemic in Manchester but may still reach up to 10-times the amount admitted for arsenic in drinking water in the European Union and the US.
Alcohol Metabolism & Acetaldehyde Formation
Complete abstinence from alcohol is crucial to prevent further damage to the heart muscle. The relationship between alcohol and heart failure has been extensively studied. According to clinical research, most of the symptoms of alcoholic-induced cardiomyopathy occur when the disease is irreversible and advanced and may start with signs of congestive heart failure. It can also result from alcohol use disorder (AUD) and alcohol dependence. As a net effect, negative inotropism may result and contribute to heart failure. Clinical observation confirmed that several days to weeks of drinking show higher and weeks of abstinence lower pressures.
Seeking professional assistance, attending Alcoholics Anonymous meetings, or accessing other support networks can provide invaluable help to overcome alcohol use disorder. Although lab tests aren’t useful in diagnosing the condition, they can help check the severity of your heart condition. This may be experienced as pressure, overall tightness, or a burning sensation in the chest.
Long-Term Outlook for ACM
These changes are related to both direct alcohol toxicity on cardiac cells and the indirect toxicity of major alcohol metabolites such as acetaldehyde. Alcohol-induced cardiomyopathy remains a relevant health problem, for which the mainstay of treatment is alcohol abstinence. In recent years, basic and clinical research has shed light on its pathogenesis, which includes direct toxic effects of alcohol on the myocardium, oxidative stress, mitochondrial dysfunction, and genetic susceptibility.
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