Cardiomyopathy - alcoholic

Alternative names

Alcoholic cardiomyopathy

Definition

Alcoholic cardiomyopathy is a disorder in which excessive, habitual use of alcohol weakens the heart muscle. The heart cannot pump blood efficiently, and this in turn affects the lungs, liver, brain, and other body systems.

Causes, incidence, and risk factors

Drinking alcohol in excessive quantities has a directly toxic effect on heart muscle cells. Alcoholic cardiomyopathy is a form of dilated cardiomyopathy caused by habitual alcohol abuse.

Alcoholic cardiomyopathy causes poor heart function because the heart muscle becomes too weak to pump efficiently. The condition leads to heart failure. Lack of blood flow affects all parts of the body, resulting in damage to multiple tissues and organ systems.

The disorder is most commonly seen in males ages 35 to 55 years old, but it may may develop in anyone who consumes too much alcohol over a long period of time. Alcoholic cardiomyopathy may be indistinguishable from idiopathic dilated cardiomyopathy if the history of drinking is not known.

Symptoms

Symptoms are usually absent until the disease is in an advanced stage. At that point, the symptoms occur because of heart failure. Patients also often show muscular weakness because of a direct alcohol effect on muscles (alcoholic myopathy).
Possible symptoms include:

• Ankle, feet, and leg swelling
  
• Overall swelling
  
• Loss of appetite
  
• Shortness of breath, especially with activity
  
• Breathing difficulty while lying down
  
• Fatigue, weakness, faintness
  
• Decreased alertness or concentration
  
• Cough containing mucus, or pink, frothy material coughed up
  
• Decreased urine output (oliguria)
  
• Need to urinate at night (nocturia)
  
• Sensation of feeling the heart beat (palpitations)
  
• Pulse may feel irregular or rapid
  

Signs and tests

The examination and tests are directed at diagnosing and evaluating heart failure . Alcoholic cardiomyopathy is usually diagnosed when chronic heavy drinking is discovered as a cause of the heart failure.

Alcoholic patients often also have vitamin deficiencies, especially thiamin deficiency. (The more severe form of this deficiency is beriberi.) Thiamin deficiency also causes alcoholic brain damage (Korsakoff's syndrome, Wernicke-Korsakoff syndrome).