Overview

    Alcoholic cardiomyopathy is a form of heart disease caused by alcohol abuse. Long-term alcohol abuse weakens and thins the heart muscle. The damaged muscle cannot pump blood as it should, which deprives the body tissues of oxygen. This can lead to multiple other health problems and even death.

    Men between the ages of 35 and 50 have alcoholic cardiomyopathy more than any other group. However, women can also have the disease and because of typically smaller body sizes, can develop the condition after less alcohol use than men.

    What Are the Causes of Alcoholic Cardiomyopathy?

    Alcohol abuse causes multiple physical and chemical changes in the body that affect many internal organs, including the heart. Alcoholic cardiomyopathy damages the heart in several ways:

    • The damaged heart muscle cannot pump enough blood to the rest of the body.
    • When the left ventricle cannot pump out all the blood, the heart enlarges to hold the extra blood.
    • Blood pressure increases to make up for reduced heart production. This causes further strain on the heart and blood vessels.
    • Eventually, the heart muscle, valves, and blood vessels may fail from the damage and overwork.

    What Are the Symptoms of Alcoholic Cardiomyopathy?

    Alcoholic cardiomyopathy is a disease that can show symptoms in many parts of the body. People with the disease often have:

    • shortness of breath
    • swelling of the legs
    • rapid and irregular heartbeat
    • rapid and irregular pulse
    • fatigue, weakness, dizziness, fainting
    • an enlarged liver
    • cough that produces a frothy, pink mucus

    The disease can lead to congestive heart failure and death.

    How Is Alcoholic Cardiomyopathy Diagnosed?

    A person with alcoholic cardiomyopathy may show no symptoms at first. Sometimes symptoms do not appear until the disease is critical. The patient’s full medical history and a physical examination will be needed for a diagnosis. Some lab tests and X-rays may also be necessary.

    Office Exam

    During the office exam, the doctor will first check the pulse and blood pressure, and listen to the lungs and heart. The doctor can detect potential signs of congestive heart failure, including:

    • enlarged heart
    • sounds of a heart murmur from valve damage
    • sounds of congestion in the heart and lungs
    • swelling of the (jugular) vein in the neck
    • swelling of the legs, ankles, and feet

    The doctor must have an honest history of the extent of alcohol abuse to make a diagnosis and develop a treatment plan.

    Lab Tests

    Lab tests are not useful in diagnosing alcoholic cardiomyopathy. However, they can help check other body systems and organs for damage. Tests include blood chemistry, liver function, and cholesterol levels.

    Diagnostic Imaging

    There are several kinds of diagnostic imaging that can examine the heart and lungs:

    • Chest X-rays can show if the heart is already enlarged. X-rays can also reveal any pulmonary congestion or pleural effusions (fluid in the lungs). These are all common in alcoholic cardiomyopathy.
    • An echocardiogram can show
      • an enlarged heart
      • decreased pumping volume from the left ventricle
      • leaking heart valves
      • high blood pressure
      • blood clots
      • and enlarged left ventricle
    • An electrocardiogram (ECG) can check the electrical signals that control the heartbeat. Alcoholic cardiomyopathy can cause problems with heart rhythm (arrhythmias) that will show up on an ECG.
    • A heart catheterization may show any coronary artery disease.

    How Is Alcoholic Cardiomyopathy Treated?

    The first step is total and permanent abstinence from alcohol. Next, diet and lifestyle changes will be necessary to relieve the burden on the heart. The doctor may order a low-salt diet and diuretics. Restricted fluid intake may also be needed to relieve pressure on the heart from fluid retention. The doctor may prescribe ACE inhibitors and beta-blockers to manage the high blood pressure. If the heart is severely damaged, the doctor may recommend an implantable defibrillator or a pacemaker to improve heart function.

    What Is the Long-Term Outlook?

    Alcoholic cardiomyopathy can damage the body. However, the damage may be partially reversible if the condition is caught early and the patient stops all alcohol use. Recovery depends on how long the patient has abused alcohol and how much was consumed. The prognosis for complete recovery is poor if the heart is already damaged.