The key to diagnosis is a personal history of chronic heavy alcohol use and the absence of other etiologies. In general, most people who stop drinking alcohol will feel better over the next three to six months. However, certain symptoms may start to improve even sooner, depending on treatments and the severity of your case.
Mental & Emotional Effects
The pattern of excessive drinking, regardless of the frequency, can lead to the development of this condition. Ethanol is converted into acetaldehyde, a toxic substance, and free radicals during this process. The first paper to assess the natural history and long-term prognosis of ACM was published by McDonald et al[69] in 1971. He recruited 48 patients admitted to hospital with cardiomegaly without a clear aetiology and severe alcoholism. The only factor to predict a poor outcome was the duration of symptoms before admission.
Associated Data
Since alcohol addiction is a chronic condition with no cure, you’ll need to continually manage it. When compared to other types of cardiovascular disorders, alcoholic cardiomyopathy is not common. In fact, it is considered relatively rare when compared to conditions like coronary artery disease, heart failure, or arrhythmias.
EFFECTS OF ALCOHOL WITHDRAWAL
Chronic liver disease such as cirrhosis may in turn affect the heart and the whole cardiovascular system, leading to a syndrome named cirrhotic cardiomyopathy (CCM). Thus, CCM has been introduced as an new entity separate of the cirrhosis etiology. Increased cardiac output due to hyperdynamic circulation, left ventricular dysfunction (systolic and diastolic), and certain electrophysiological abnormal findings are pathophysiological features of the disease. The underlying mechanisms might include the impaired β‑receptor and calcium signaling, altered cardiomyocyte membrane physiology, elevated sympathetic nervous tone and increased activity of vasodilatory pathways [44]. In pathophysiological terms, heart failure in liver cirrhosis belongs to the hyperdynamic cardiomyopathies. The majority of the echocardiographic studies performed on asymptomatic alcoholics found only mild changes in their hearts with no clear impairment of the systolic function.
Elevations in troponin can signify heart damage or an increase in cardiac output that results in demand ischemia. This is where the heart has an increased need for oxygen that exceeds the body’s ability to supply it. Ask any patient presenting with new heart failure of unclear etiology about their alcohol history, with attention to daily, maximal, and lifetime intake and the duration of that intake. In fact, Brandt et al.54 https://ecosoberhouse.com/ observed that in ALDH2-deficient mice, the most important increase in mitochondrial superoxide levels (which is the major species of ROS) is due to acetaldehyde, not ethanol. By inhibiting NOX2 (the most important superoxide-producing enzyme) with apocynin, they observed a decrease in ethanol- and acetaldehyde-induced superoxide levels. What you should expect with this condition depends strongly on several factors.
- Chronic and heavy alcohol use can essentially poison the heart muscle cells, causing inflammation, enlargement of the heart, and scarring (fibrosis), all of which impair the heart’s ability to function properly.
- These include damaging factors such as acetaldehyde or ROS, cardiac fibrosis, or apoptosis.
- Those who don’t fully recover are also likely to need this kind of treatment indefinitely.
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- Since those initial descriptions, reports on several isolated cases or in small series of patients with HF due to DCM and high alcohol intake have been published[15-17].
Thus, although there is a certain degree of consensus regarding the recommendation of full alcohol withdrawal in ACM, it is yet to be resolved whether moderate alcohol consumption is sufficient to achieve an improvement in the prognosis of these patients. The latest two papers to be published, unlike previous papers, reported worse outcomes for ACM patients compared to DCM patients. In the first of these studies, Fauchier et al[11] studied 50 patients with ACM and 84 patients with DCM between 1986 and 1997. Although up to 81% of ACM patients received an ACEI, none received beta-blockers and the use of spironolactone was not specified, although it was probably quite low. Also, current common cardiac therapies such as ICD and CRT devices were not used because of the period when the study was conducted.
- However, during the time that these haemodynamic changes appeared, some researchers identified a possible decrease in the ejection fraction and other parameters related to systolic function[32-39].
- Your doctor will also ask you about your medical history and drinking habits.
- ACM may interfere with your heart’s electrical signals and cause arrhythmias, potentially leading to palpitations, dizziness, fainting, or even sudden cardiac arrest in extreme cases.
- Your healthcare provider will likely recommend that you also focus on improving your diet in ways that help your heart.
- In spite of the high prevalence of excessive alcohol consumption and of its consideration as one of the main causes of DCM, only a small number of studies have analysed the long-term natural history of ACM.
As women typically have a lower BMI than men, a similar amount of alcohol would reach a woman’s heart after consuming smaller quantities of alcohol. Data on the amount alcoholic cardiomyopathy is especially dangerous because of alcohol consumption required to cause ACM are limited and controversial. For some people, a combination of factors could also lead to a weakened heart.
In some cases, medication or a heart transplant may be the best treatment option. Around 40–80% of people with ACM who continue drinking alcohol die within 10 years of their diagnosis. This can cause heart inflammation, leading to an atypically fast heart rhythm, such as atrial fibrillation (AF).
Future studies with a strict classification of non-drinkers and drinkers will help clarify whether complete abstinence is mandatory for ACM patients. In the interim it seems appropriate to continue discouraging any alcohol consumption in these patients, as it would be difficult for them to maintain a limited alcohol intake considering their history of alcohol dependence and abuse. Additionally, echocardiographic data suggest that subjects who do not fully withdraw from alcohol consumption, but who reduce it to moderate amounts recover LVEF in a similar manner to strict non-drinkers. Thus, Nicolás et al[73] studied the evolution of the ejection fraction in 55 patients with ACM according to their degree of withdrawal.
Ways to stay healthy
This may be experienced as pressure, overall tightness, or a burning sensation in the chest. This is most commonly seen in the legs, ankles and feet, but it can sometimes occur in the abdomen. Fluid retention can be significant, making a person look like they have gained weight suddenly despite a loss of appetite that generally accompanies ACM. Healthwise, Incorporated, disclaims any warranty or liability for your use of this information.