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Alcoholic Cardiomyopathy: Overview, Cardiac Effects of Alcohol, Quantity of Alcohol Intake in Cardiac Disease

January 19, 2024 admin No Comments

what is alcoholic cardiomyopathy

We identified main themes and sub-themes to provide a comprehensive overview of the current state of knowledge regarding ACM. By following this methodology, we aim to contribute to the existing body of knowledge on ACM, providing a reliable and up-to-date understanding of its pathogenesis, clinical features, diagnostic approaches, https://ecosoberhouse.com/ treatment options, and potential preventive strategies. Since myocardium requires a high energy supply to maintain persistent sarcomere contractions, it was supposed that alcohol could exert its damaging effect on the mitochondrial energy supply system, with the disruption of oxidative control mechanisms [26,100].

7. End-stage ACM

In ACM, it is relevant to consider the treatment of the other alcohol-induced systemic damage, such as liver cirrhosis, malnutrition, and vitamin and electrolyte disturbances [2,11,52]. Notably, in patients with a history of chronic alcohol consumption complicated by significant myocardial dysfunction and chronic malnutrition, re-feeding syndrome may increase the cardiac dysfunction. Therefore, physicians should be aware of the risk of new cardiomyopathy in patients with these overlapping diagnoses [144]. Control of these alcohol-related systemic diseases, as well as the strict control of the presence of other heart risk factors (tobacco, cocaine, arterial hypertension, diabetes mellitus, or anemia) contributes to ACM improvement [10,20,23,37,52]. Atrial fibrillation should be controlled with chronotropic drugs such as digoxin or diltiazem and anticoagulant treatment to avoid arterial embolisms [60,145]. The treatment of episodes of heart failure in ACM does not differ from that performed in idiopathic-dilated CMP [52,54].

Pathological Aspects of ACM

Because hypertension may directly contribute to left ventricular (LV) dysfunction, this may be a confounding comorbidity in persons who abuse alcohol, and it should be differentiated from pure forms of alcoholic cardiomyopathy. The signs and symptoms of alcoholic cardiomyopathy (ACM) can vary depending on the severity of the condition.[6] In the early stages, people with ACM may not experience any symptoms. However, as the condition progresses, they may experience symptoms such as fatigue, shortness of breath, palpitations, and swelling of the legs and ankles.[6] They may also experience chest pain, dizziness, and fainting. In some cases, ACM can cause arrhythmias or irregular heartbeats, which can be life-threatening. Askanas et al[21] found a significant increase in the myocardial mass and of the pre-ejection periods in drinkers of over 12 oz of whisky (approximately 120 g of alcohol) compared to a control group of non-drinkers.

Diagnosis and Tests

  • The AHA suggests moderate alcohol consumption for those who choose to drink, defining moderation as up to one drink per day for women and up to two drinks per day for men.
  • Your liver detoxifies and removes alcohol from your blood through a process known as oxidation.
  • Notably, in patients with a history of chronic alcohol consumption complicated by significant myocardial dysfunction and chronic malnutrition, re-feeding syndrome may increase the cardiac dysfunction.
  • Consulting with a healthcare professional can provide personalized advice and guidance.

It is important to note that the size and strength of different alcoholic beverages can vary, so these definitions serve as general guidelines. It is always advisable to be mindful of individual tolerance and consume alcohol responsibly [4-6]. Excessive alcohol consumption represents one of the main causes of non-ischemic dilated cardiomyopathy. Alcoholic cardiomyopathy is characterized by dilation and impaired contraction of one or both myocardial ventricles. It represents the final effect of alcohol-induced toxicity to the heart. Several pathophysiological mechanisms have been proposed at the basis of alcohol-induced damage, most of which are still object of research.

Assess Your Risk

The percentage of effective abstinence achievement on these patients submitted to specific programs ranges from 50% to 60% [8,9]. Therefore, many ACM subjects are not able to effectively control their alcohol-consumption rates. Therefore, any decrease in the previous quantity of alcohol consumption may improve, to some degree, cardiac health [51]. Since ACM is related to frequent perioperative events and high postoperative morbidity [139], detection and treatment of ACM is compulsory to avoid anesthetic and surgical complications [140].

  • Excessive intake of alcohol may result in increased systemic blood pressure in a dose-response relationship, and this may contribute to chronic myocardial dysfunction.
  • This refers to the finding in the last century that moderate alcohol consumption could be the reason for the relatively low cardiovascular disease incidence in wine-drinking regions [92].
  • G., in medieval times, when people took advantage of the vasodilating properties of alcohol to treat angina pectoris or heart failure.
  • By following this methodology, we aim to contribute to the existing body of knowledge on ACM, providing a reliable and up-to-date understanding of its pathogenesis, clinical features, diagnostic approaches, treatment options, and potential preventive strategies.
  • Medications typically include beta-blockers (for heart rhythm and blood pressure issues) and diuretics (to help your body get rid of excess fluid and swelling).
  • Along with developing heart damage, patients with ACM may also damage other organs, such as the liver, central and peripheral nervous system, skeletal muscle, pancreas, and digestive tract, and are exposed to an increased risk of cancer [24,63,64].

International Patients

what is alcoholic cardiomyopathy

If you think you may have cardiomyopathy or are worried about your risk, make an appointment with your healthcare professional. At ultrastructural level, dysfunction on the transition pore in the inner membrane is related to ethanol exposure [111]. In addition, ethanol induces mitochondrial-dependent apoptosis pathways with Bax and caspase activation [101]. Let your healthcare professional know if you have a family history of the condition. Thiamine (200 mg once daily), multivitamins, vitamin B-12, folate, and mineral supplementation are beneficial for patients with AC because of the significant prevalence of concomitant nutritional or electrolyte deficiencies in these patients. Animal studies have suggested a benefit from vitamins B-1 and B-12, speculated to be due to protective effects against apoptosis and protein damage.

what is alcoholic cardiomyopathy

Other treatments aim to treat the symptoms of ACM and prevent any disease complications. Alcoholic cardiomyopathy affects the heart’s ability to pump oxygen-rich blood around the body. This can cause various symptoms, including shortness of breath, fluid retention, and alcoholic cardiomyopathy fainting. For instance, healthcare professionals can carry out a stress test or heart catheterization to rule out coronary artery disease (CAD), which is another cause of cardiomyopathy. Often, when a doctor suspects cardiomyopathy, they will order an echocardiogram.

Although anticoagulation may be of benefit to patients with profound LV dysfunction and atrial fibrillation, the risks must be weighed heavily in this patient population. Around 40–80% of people with ACM who continue drinking alcohol die within 10 years of their diagnosis. Without an adequate supply of blood and oxygen, the body’s organs and tissues can no longer function properly. This can result in various symptoms, including fluid retention and episodes. The key to diagnosis is a personal history of chronic heavy alcohol use and the absence of other etiologies. The only way to cure alcohol-induced cardiomyopathy is with a heart transplant.

If it takes too long — even by tiny fractions of a second— that delay can cause your heart to beat out of sync (a problem called dyssynchrony). Similarly, alcohol can have a toxic effect on your heart and cause scar tissue to form. That scar tissue can also cause potentially life-threatening arrhythmias (irregular heart rhythms). To make a diagnosis, your doctor will perform a physical examination and ask you about your medical history.

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