Alcoholic cardiomyopathy

Alcoholic cardiomyopathy
ICD-10	I42.6
ICD-9	425.5
MedlinePlus	000174
eMedicine	med/286
MeSH	D002310

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Alcoholic cardiomyopathy is a disease in which the abuse of alcohol use damages the heart muscle causing heart failure.

Pathophysiology

Alcoholic cardiomyopathy is a type of Dilated cardiomyopathy. Due to the abuse of alcohol the heart may become weakened and will not pump blood efficiently leading to heart failure. It can effect other parts of the body if the heart failure is severe.

Epidemiology and Demographics

It is more prevalent in middle age men 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

See Also

• Cardiomyopathy