Alcoholic cardiomyopathy is a form of heart failure that is brought on by long term abuse of alcohol. Also referred to as dilated cardiomyopathy, this condition can cause the ventricles of the heart to become enlarged. The heart muscle is also weakened and cannot adequately pump blood through the rest of the body.
Once alcohol is consumed by mouth, it is absorbed by the stomach and small intestine and then passes into the liver. In the liver, alcohol is broken down by the enzyme alcohol dehydrogenase. For those patients who consume excessive amounts of alcohol, the liver is unable to process it fast enough and the alcohol builds up in the bloodstream.
High levels of alcohol in the bloodstream can be toxic to cells of the heart. Damage to the heart muscle, or alcoholic cardiomyopathy, may occur in a patient with a long term pattern of consuming seven to eight drinks every day. Long term in this case refers to patients who have been drinking heavily for five to 10 years.
Since alcohol is only one of the causes of dilated cardiomyopathy, it is important that the physician make a correct diagnosis for this disorder. The physician must take a complete patient history and ask very specific questions regarding alcohol use. Questions must be asked that would reveal the amount and frequency of alcohol intake. Many patients who drink heavily may under report the amount of alcohol that is being consumed.
The patient may not have any symptoms during the early stages of alcoholic cardiomyopathy. Eventually the patient may notice symptoms of heart failure that include shortness of breath, congestion in the lungs, and swelling in the legs. If the heart cannot pump blood properly through the body, the patient may experience fatigue and retention of fluids.
Several tests may be done to diagnose alcoholic cardiomyopathy. The physician may order a chest X-ray which would show that the heart is enlarged that there may be congestion in the lungs. An echocardiogram, which uses sound waves to image the heart, may also be used to diagnose this disorder. The activity of the heart can be measured during an electrocardiogram, in which electrodes on the chest record electrical impulses.
The most effective treatment for alcoholic cardiomyopathy is complete abstinence from alcohol. In the early stages of the disease, abstinence may halt the progression of symptoms. Some damage to the heart may be reversible. If the patient is unable to stop drinking, the physician may need to identify a rehabilitation program.