What is alcoholic cardiomyopathy?

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 your heart can’t pump blood efficiently, the lack of blood flow disrupts all your body’s major functions. This can lead to heart failure and other life-threatening health problems.

Learn more: Alcohol abuse and alcoholism: What are the differences? »

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 more than four drinks a day or more than 14 drinks per week.
  • For women, heavy drinking is more than three drinks a 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.

Call your doctor right away if you think 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 (CHF).

People with alcoholic cardiomyopathy might have:

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 your 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. You may also need some laboratory tests and X-rays.

Physical exam

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. These simple tests allow your doctor to 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 your alcohol use, including the number and amount of drinks you have each day. This will make it easier for them to make a diagnosis and develop a treatment plan.

Laboratory tests

Lab tests aren’t useful in diagnosing alcoholic cardiomyopathy. However, they can help your doctor check the degree of your heart dysfunction as well as check other organs for damage. Your doctor may order the following tests to assess how your other organs are working:

Diagnostic imaging

There are several types of imaging tests that can examine the heart and lungs:

  • Chest X-rays or a chest CT scan can show if the heart is already enlarged. They can also show any congestion or fluid in the lungs. These are all common signs of alcoholic cardiomyopathy.
  • An echocardiogramuses sound waves to make pictures 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 show any irregular heartbeat.

Learn more: What is arrhythmia? »

The first step of treatment is to stop drinking alcohol completely. Your doctor can help to prevent you from having symptoms of alcohol withdrawal. You’ll also need to make adjustments to your diet and lifestyle. Your doctor may suggest that you:

  • follow a low-salt diet
  • take diuretics to increase the removal of water and salt from your body through urination
  • limit how much fluid you drink to ease pressure on your heart from fluid retention

Your doctor might prescribe ACE inhibitors and beta-blockers to help lower your blood pressure. If your heart is severely damaged, your doctor may recommend an implantable defibrillator or pacemaker to help your heart work.

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.