Alcoholic cardiomyopathy: Difference between revisions
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==Epidemiology and Demographics== | ==Epidemiology and Demographics== | ||
Alcoholic cardiomyopathy is more prevalent in middle age males between the ages of 35-50. | |||
==Diagnosis== | ==Diagnosis== | ||
Revision as of 18:34, 23 January 2013
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
Alcoholic cardiomyopathy is a disease in which the abuse of alcohol use damages the heart muscle causing heart failure. It is characterized by constellation of findings which includes a history of excessive alcohol intake, physical signs of alcohol abuse, heart failure, and supportive findings consistent with dilated cardiomyopathy.
Pathophysiology
Alcoholic cardiomyopathy is a type of dilated cardiomyopathy. Excessive use of alcohol has a direct toxic effect on the heart muscle cells. The heart muscle becomes weakened and cannot pump blood efficiently. The lack of blood flow affects all parts of the body, resulting in damage to multiple tissues and organ systems. Alcohol may also directly damage the liver.
Epidemiology and Demographics
Alcoholic cardiomyopathy is more prevalent in middle age males between the ages of 35-50.
Diagnosis
History
The quantity and duration of alcohol consumption as well as the nutritional status of the patient should be inquired about.
Abnormal heart sounds, murmurs
Echocardiogram abnormalities and cardiac catheterization or angiogram to rule out coronary artery blockages
Symptoms
Symptoms presented by the occurrence of alcoholic cardiomyopathy are the result of the heart failing and usually occur after the disease has progressed to an advanced stage. Therefore the symptoms have a lot in common with other forms of cardiomyopathy:
- Anasarca or overall swelling
- Cachexia or loss of appetite
- Cough containing mucus, or pink, frothy material
- Decreased alertness or decreased concentration
- Dyspnea or shortness of breath with activity
- Faintness
- Fatigue
- Irregular pulse or rapid pulse
- Nocturia or a need to urinate at night
- Oliguria or decreased urine output
- Orthopnea or breathing difficulty while lying down
- Palpitations
- Pedal edema, ankle swelling, feet swelling, and leg swelling
- Weakness
Electrocardiogram
- Reduced QRS voltage may be present
- T wave alternans may be present
Chest X-ray
- Cardiomegaly or an enlarged heart is present
Treatment
Treatment for Alcoholic cardiomyopathy involves a lifestyle change as well as treatment through medication. If the heart failure is severe the effectiveness of treatment will be limited.
Medication may include, ACE inhibitors and Beta Blockers which are commonly used with other forms of cardiomyopathy to reduce the strain on the heart. The medication may include diuretics to help remove the excess liquid in the body. Persons with congestive heart failure maybe considered for surgery insert and ICD or a pacemaker which can improve the heart function. In cases where the heart failure is irreversible and declining a heart transplant maybe considered. Lifestyle changes would include an absitnance from alcohol, a low sodium diet and a reduction in the fluids consumed.
Treatment will possibly prevent the heart from deterioration but is unlikely to reverse the reduced function that has already occurred