Alcoholic cardiomyopathy is a form of heart disease caused by alcohol abuse. Long-term alcohol abuse weakens and thins the heart muscle, affecting its ability to pump blood. When the heart can’t pump blood efficiently, the lack of blood flow disrupts all your major body functions. This can lead to heart failure and other life-threatening health conditions.
Alcoholic cardiomyopathy is most common in men between the ages of 35 and 50, but the condition can affect women as well. People with alcoholic cardiomyopathy often have a history of heavy, long-term drinking, usually between five and 15 years. Heavy drinking is alcohol consumption that exceeds the recommended daily limits. For men, heavy drinking is defined as more than four drinks per day or more than 14 drinks per week. For women, it’s defined as more than three drinks per day or more than seven drinks per week.
Alcoholic cardiomyopathy doesn’t always cause symptoms. When symptoms do occur, they’re often those of heart failure. They commonly include fatigue, shortness of breath, and swelling of the legs and feet.
It’s important to call your doctor right away if you believe you have alcoholic cardiomyopathy. Prompt treatment can help prevent the disease from getting worse and developing into a more serious condition, such as congestive heart failure.
People with alcoholic cardiomyopathy might experience:
- shortness of breath
- swelling of the legs, feet, and ankles
- dizziness or fainting
- loss of appetite
- trouble concentrating
- a rapid and irregular pulse
- a cough that produces a frothy, pink mucus
- a change in urine output
It’s important to note that alcoholic cardiomyopathy may not cause any symptoms until the disease is more advanced. At that point, the symptoms are often the result of heart failure.
Alcohol abuse has a toxic effect on many of your organs, including the heart. The toxicity of alcohol damages and weakens the heart muscle over time. This makes it difficult for the heart to pump blood efficiently. When it can’t pump out enough blood, the heart starts to expand to hold the extra blood. This causes the heart to become thinned and enlarged. Eventually, the heart muscle and blood vessels may stop functioning properly due to the damage and strain.
To make a diagnosis, your doctor will perform a physical examination and ask you about your medical history. Some laboratory tests and X-rays may also be necessary.
During the exam, your doctor will check your pulse and blood pressure. They’ll also listen to your lungs and heart to check for any abnormal sounds. Your doctor can identify potential signs of alcoholic cardiomyopathy or heart failure, including:
- an enlarged heart
- sounds of a heart murmur from valve damage
- sounds of congestion in the heart and lungs
- swelling of the jugular veins in the neck
- swelling of the legs, ankles, and feet
Your doctor will also ask you about your medical history and drinking habits. It’s important to be honest with your doctor about the extent of alcohol abuse. This will make it easier for them to make a diagnosis and develop a treatment plan.
Lab tests aren’t useful in diagnosing alcoholic cardiomyopathy. However, they can help check other organs for damage. Your doctor may order the following tests to assess how your other organs are working:
- a blood chemistry panel, which measures the levels of certain substances in the blood
- a liver function test, which helps detect liver inflammation and damage
- a cholesterol test, which checks the cholesterol levels in the blood
There are several types of imaging tests that can examine the heart and lungs:
- Chest X-rays or chest CT scan can show if the heart is already enlarged. They can also reveal any congestion or fluid in the lungs. These are all common signs of alcoholic cardiomyopathy.
- An echocardiogram uses sound waves to produce images of your heart. It can show:
- an enlarged heart
- leaking heart valves
- high blood pressure
- blood clots
- An electrocardiogram (EKG) can check the electrical signals that control your heartbeat. Alcoholic cardiomyopathy can disrupt your heart rhythm, causing it to beat too fast or too slow. An EKG will detect an irregular heartbeat.
The first step of treatment is to stop drinking alcohol completely. You’ll also need to make adjustments to your diet and lifestyle. Your doctor may recommend that you follow a low-salt diet and take diuretics, which increase the removal of water and salt from the body.
Restricted fluid intake may also be needed to relieve pressure on the heart from fluid retention. Your doctor might prescribe ACE inhibitors and beta-blockers to manage your high blood pressure. If your heart is severely damaged, your doctor may recommend an implantable defibrillator or pacemaker to improve heart function.
The outlook for people with alcoholic cardiomyopathy varies depending on how long alcohol was abused and how much alcohol was consumed during that time. These factors determine the severity of heart damage. In cases where the damage to the heart is severe, the chances of complete recovery are low. Once the damage is considered irreversible, it’s difficult for the heart and rest of the body to recover.
However, if alcoholic cardiomyopathy is caught early and the damage isn’t severe, the condition can be treated. In some cases, the damage can even be reversed. It’s very important to stick with the treatment plan and to stop drinking alcohol during recovery.