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

All previous mechanisms can induce myocyte apoptosis through the induction of mitochondrial damage and oxidative stress 12. One of the relevant facts in ACM is the existence of a clear gender difference, women being more susceptible to the toxic effects of alcohol than men at the same level of lifetime ethanol consumption 93,94. This fact has been assessed with echocardiographic monitoring in women consuming high doses of ethanol both in the subclinical period of disease 46 as well as in the clinical period when congestive heart failure https://ecosoberhouse.com/ appears 95.

• This can cause various symptoms, including shortness of breath, fluid retention, and fainting.
• Virtual consultations allow you to receive personalized care, discuss symptoms, and adjust treatments without in-person visits, especially beneficial for those with mobility issues or living in remote areas.
• These treatments are designed to reduce the long-term risk of cardiovascular disease and to alleviate symptoms and improve quality of life.
• A person can speak with a doctor about any concerns regarding lifestyle changes.
• Certain microscopic features may suggest damage secondary to alcohol causing cardiomyopathy.
• “There’s this idea that a ‘big guy’ can ‘handle his liquor’ more than a smaller person, but there are also big guys who may have more body fat or other conditions that may make the long-term effects of alcohol worse,” he says.

Alcoholic Cardiomyopathy Treatment

Over time, the toxicity of alcohol weakens the heart muscle, making it less effective at pumping blood. Evidence of altered bioenergetics or mitochondrial dysfunction has been observed in various investigations of ethanol effect on the heart. Disrupted bioenergetics and oxidative phosphorylation indices and a change in the ultrastructure of the mitochondria may be the cause of such dysfunctions. This can be understood through clinical observations that highlight the mitochondria as the main target of oxidative damage. When reactive oxygen species (ROS) are produced in excessive manners due to heavy alcohol consumption, it damages mitochondrial DNA, resulting in mitochondrial injuries.

Lifestyle Modifications

According to the Centers for Disease Control and Prevention (CDC), heavy drinking is defined as more than 8 drinks per week for women and more than 15 drinks per week for men. Binge drinking, which involves consuming large amounts of alcohol in a short period, can also contribute to heart damage. 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, what is alcoholic cardiomyopathy or anemia) contributes to ACM improvement 10,20,23,37,52.

Outlook, Diagnosis & Treatment Options

Similarly, people with pre-existing heart conditions, such as coronary artery disease, are more vulnerable to alcohol’s effects on the heart muscle. The quantity of alcohol consumed daily and the duration of alcohol misuse are linked to the development of ACM, although the precise thresholds for causing cardiac dysfunction remain unknown. The risk of ACM significantly increases with alcohol intake exceeding 80 g per day for a minimum of five years 3. According to the American Heart Association (AHA) and other US-based guidelines, alcohol intake recommendations are provided to promote responsible drinking habits and maintain overall health. 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. It is important to note that these guidelines apply to healthy adults and should be adjusted for individuals with certain health conditions or those taking specific medications.

• It’s important to note that alcoholic cardiomyopathy may not cause any symptoms until the disease is more advanced.
• Excessive alcohol consumption represents one of the main causes of non-ischemic dilated cardiomyopathy.
• Ischemic heart disease is also linked to risk factors like high cholesterol, high blood pressure, smoking, and diabetes, rather than alcohol use.
• However, since it includes moderate alcohol consumption of red wine, this aspect should be clearly avoided in subjects affected by ACM.

During the 20th century, the physiopathological basis for ACM was progressively established 6. At present, ACM is defined as a dilated cardiomyopathy of toxic origin with low left-ventricle ejection fraction, chamber dilatation, and progression to congestive heart failure drug addiction 18,52,53. Excessive EtOH consumption is one of the main causes of non-ischemic dilated cardiomyopathy (CMP), representing around one-third of cases 30.

6. Cardiac Hypertrophy and Remodeling in ACM

In fact, the particular effects that ethanol produces in a specific organ depend on several factors 18,19. One is the physical characteristics of ethanol itself, with a low molecular size, high distribution capacity, and high tissue reactivity. In addition, there is a relevant role on each organ, particularly on defense and adaptive mechanisms, with a clear induction of anti-oxidant, metabolic, and anti-inflammatory protective responses as a result of ethanol aggression 18,25,26. This multi-factorial effect is attributed to genetic factors 27 and ethnic 28 variability. The final damage is an equilibrium between the intensity of damaging effects and the possibility of defense, plasticity, regeneration, and adaptation for every specific organ 29,30,31.

Health Conditions with Similar Symptoms to Alcoholic Cardiomyopathy

• Similarly, people with pre-existing heart conditions, such as coronary artery disease, are more vulnerable to alcohol’s effects on the heart muscle.
• However, its modern clinical report was delayed until the 19th century, where specific ACM cases were clinically described in Germany and England 1.
• Patients may notice improvements in mood and mental health within a few weeks, though full benefits may take several months.
• S3 gallop sound along with apical pansystolic murmur due to mitral regurgitation is often heard.

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. Another differential diagnosis includes myocarditis which is an inflammation-induced cardiomyopathy often caused by viral infections or an autoimmune response. The etiology behind alcoholic cardiomyopathy lies in the direct toxic effects of alcohol on the heart muscle. Chronic alcohol consumption can cause the heart to enlarge and become weaker, leading to dilated cardiomyopathy.