Alcoholic Cardiomyopathy: Signs, Symptoms, And Treatment

Cardiomyopathy is a disease in the muscles of the heart. “Cardio” refers to the heart, where “myopathy” refers to muscle disease.

Dilated cardiomyopathy refers to a weakening of heart muscles, enlarging the chambers within the heart that pump blood. Alcoholic cardiomyopathy is a type of heart disease that is the result of alcohol abuse.

Over time, excessive alcohol consumption causes the muscles of the heart to thin and become weak. This negatively impacts the heart’s ability to pump blood through the body.

Without the ability to maintain proper blood flow, the function of all major organ systems in the body is interrupted. The toxic effects of alcohol abuse can be heart failure, organ failure, or a multitude of other health issues, some more dangerous than others.

Who Is At Risk For Alcoholic Cardiomyopathy?

Risk factors for alcoholic cardiomyopathy include individuals who typically have engaged in heavy drinking for at least five to 15 years. Those who struggle with an alcohol use disorder are at significant risk for developing alcoholic cardiomyopathy.

Heavy drinking refers to alcohol consumption and is defined by the National Institute on Alcohol and Alcoholism (NIAAA) as over three drinks for women and four drinks for men per day.

The Centers for Disease Control and Prevention (CDC) expanded that definition to include alcohol use that is more than seven drinks per week for women and 14 per week for men.

Men between the ages of 35 and 50 who drink heavily are most at risk for developing alcoholic cardiomyopathy. Women are also at risk if they chronically abuse alcohol over a long period of time.

Binge drinking, or drinking a lot of alcohol at one time, can also contribute to health problems, including developing a chronic alcohol abuse problem.

Symptoms Of Alcoholic Cardiomyopathy

Unfortunately, alcoholic cardiomyopathy does not typically present with progressive symptoms. The symptoms that many people experience tend to indicate heart failure.

A person with alcoholic cardiomyopathy may experience a prevalence of the following clinical characteristics and symptoms of the disease:

• fatigue
• dizziness
• fainting
• shortness of breath
• adema (swelling of feet, ankles or legs)
• irregular, fast heartbeat
• high diastolic blood pressure
• no appetite
• changes in urine
• cough with pink, foamy mucus

All of these symptoms contribute to the pathophysiology of alcoholic cardiomyopathy.

If these symptoms are present, the individual should seek medical attention immediately. Addressing the symptoms as quickly as possible may help keep alcoholic cardiomyopathy from progressing further into congestive heart failure, or some other serious health issue.

Alcoholic Cardiomyopathy Causes

Other types of cardiomyopathy, such as dilated cardiomyopathy (DCM), may not be caused by alcohol abuse, but by genetics or other factors. While dilated cardiomyopathy is not preventable, alcoholic cardiomyopathy is a preventable condition.

Alcohol use damages the body. Chronic, long-term alcohol abuse is toxic to vital organs. Alcohol may also be referred to as ethanol, grain alcohol, or spirits. Ethanol damages the body when it is abused.

When the liver metabolizes ethanol, it produces metabolites like acetaldehyde. Acetaldehyde toxicity is what causes hangovers, and can also cause scar tissue formation to membranes in the body. This can lead to a disruption in ventricular function.

The cardiac muscles are significantly affected by alcoholism. The heart muscles deteriorate, making them weak. As a result, the heart cannot pump blood as well due to the damage.

The damaged heart muscles (myocardium) allow blood to remain in the right and left ventricles of the heart, and the heart thins out and expands to hold the accumulating blood.

Over time, the heart becomes enlarged and is under excessive strain to function. This is dangerous and can be fatal.

Diagnosing Alcoholic Cardiomyopathy

An appointment with a medical professional will be needed to diagnose alcoholic cardiomyopathy, and you may be referred to a cardiology department.

Cardiology Exams

At the cardiology appointment, an exam will include a simple pulse and blood pressure (hypertension) check, in addition to listening to the heart and lungs for abnormalities.

These checks will help the doctor determine if there is a risk of heart failure by indicating a potential of:

• congestion in the lungs or heart
• adema (swelling of feet, ankles, legs)
• atrial fibrillation (afib)
• heart murmur (potential valve damage)
• arrhythmias
• myocarditis
• enlarged or swollen jugular veins
• systolic dysfunction
• enlarged heart

A health history will also be taken during the coronary exam. Being completely honest with the doctor about drinking habits is extremely important. This allows them to accurately diagnose symptoms and determine the next steps to take.

Testing For Causes

Alcoholic cardiomyopathy is not an idiopathic condition. Although the symptoms of cardiac dysfunction seem to appear suddenly with this condition, it is the result of heavy alcohol use over a period of several years, resulting in cardiac fibrosis and ventricular dilation.

The doctor may also order a liver function test, to determine any liver damage, enzyme levels, check for liver disease (such as cirrhosis), as well as blood tests to check levels, including cholesterol.

While these tests will not diagnose alcoholic cardiomyopathy, they will help assess the status of organ function. Heart disease (cardiovascular disease) can lead to other organ system damage.

Imaging tests might also be ordered as well, such as chest x-rays, echocardiographic scans, or CT scans. These can reveal an enlarged heart, irregular heartbeats (arrhythmias), fluid accumulation, unstable ejection fraction, and leaking valves.

A specific type of arrhythmia, called ventricular arrhythmia, causes significant disruption in the lower heart chambers (ventricles), preventing adequate oxygen flow and increasing the incidence for cardiac arrest, myocardial infarction, or heart attack.

It is equally important for the doctor to rule out other potential causes for cardiology issues, such as coronary artery disease, high levels of angiotensin,
Untreated cardiomyopathy can lead to a number of additional health issues, including congestive heart failure.

Treating Alcoholic Cardiomyopathy

To treat alcoholic cardiomyopathy, it is imperative to stop alcohol intake entirely, as soon as possible. Most often, the safest way for someone who struggles with alcoholism to stop drinking alcohol is to attend a substance abuse treatment program that offers medically supervised detox.

Additionally, a person may be put on dietary restrictions that recommend a low-sodium diet, limiting fluid intake, and taking diuretics to further reduce sodium and fluid levels.

The more severe the alcoholic cardiomyopathy, additional treatment options may be necessary. Blood pressure medications (such as ACE inhibitors or beta-blockers), a defibrillator, or pacemakers can be prescribed if the damage to the heart is due to alcoholic cardiomyopathy.

Alcoholic Cardiomyopathy Recovery Potential

The possibility of recovery from alcoholic cardiomyopathy depends primarily on the level of damage to the heart.

This is directly related to the length of time a person has been drinking, the effects of alcohol abuse on their body, and how much alcohol they have consumed over that time frame.

Following the treatment plan and total abstinence from drinking are the best options for recovery from alcoholic cardiomyopathy.

Treatment For Alcohol Abuse Or Addiction

One of the most important things to do when initially diagnosed with alcoholic cardiomyopathy is to stop drinking. Some people may find this difficult to do on their own.

There are a number of options available, but safely detoxing from alcohol is a priority. A rehab facility that offers medications, supplements, and medical supervision during the early stages of recovery will assist in managing withdrawal symptoms.

Once free from alcohol, substance abuse treatment and medical treatments for alcoholic cardiomyopathy can begin.

Reach out to one of our treatment specialists today and find out how to get the best possible care for you or your loved one.

Written by the Addiction Resource Editorial Staff