Alcoholic cardiomyopathy: Treatments, outlook, and more

To make a diagnosis, your doctor will perform a physical examination and ask you about your medical history. Alcoholic cardiomyopathy is best managed with an interprofessional approach with the involvement of primary care physician and cardiology. Myocardial depression secondary to alcohol is initially reversible however prolonged sustained alcohol use leads to irreversible dysfunction.

The VBG results presented in the initial workup part were consistent with metabolic acidosis and respiratory alkalosis. The metabolic acidosis part could be explained by the elevated lactate alcoholic cardiomyopathy level which most likely resulted from liver failure leading to impaired metabolism of lactate. Expectedly, the body will compensate by exhaling out CO2 (respiratory alkalosis).

6. The Effect of Low-dose Ethanol on ACM

Heart myocytes are relatively resistant to the toxic effect of ethanol, developing a functional and structural compensatory mechanism able to minimize or repair the ethanol-induced myocyte damage [20,31,39]. Structurally, hypertrophy of myocytes is seen in the early stages to avoid contractile depression [52,107,125]. Myocytolysis progressively develops, disturbing the sarcomere contractile system. The heart output is progressively lower in a dose-dependent relationship with the lifetime accumulated total dose of alcohol consumed [38]. Several growth factors and cardiomyokines exert an autocrine or paracrine effect that tries to compensate for this heart damage [119,133].

This usually involves limiting your sodium (salt) and cholesterol intake and ensuring you are getting a diet that provides all essential nutrients. That’s because vitamin and mineral deficiencies are more common in individuals who are chronic heavy drinkers. In many — if not most — cases, abstaining from alcohol can be enough to help people recover from alcohol-induced cardiomyopathy.

Alcoholic cardiomyopathy and cirrhosis

Acetaldehyde is a potent oxidant and, as such, increases oxidative stress, leading to the formation of oxygen radicals, with subsequent endothelial and tissue dysfunction. Mitochondria play an essential role in cellular metabolism, and disruption of their function can have profound effects on the entire cell. The myocyte mitochondria in the hearts of persons exposed to alcohol are clearly abnormal in structure, and many believe that this may be an important factor in the development of AC. The outlook for people with alcoholic cardiomyopathy varies depending on how long alcohol was abused and how much alcohol was consumed during that time. In cases where the damage to the heart is severe, the chances of complete recovery are low. Once the damage is considered irreversible, it’s difficult for the heart and rest of the body to recover.

Other findings may include cool extremities with decreased pulses and generalized cachexia, muscle atrophy, and weakness due to chronic heart failure and/or the direct effect of chronic alcohol consumption. Alcoholic cardiomyopathy is most common in men between the ages of 35 and 50, but the condition can affect women as well. People with alcoholic cardiomyopathy often have a history of heavy, long-term drinking, usually between five and 15 years. Cardiac remodeling is a global process that myocardium establishes as a result of different aggressions [31,132].