Alcoholic Cardiomyopathy (Alcohol-Induced Heart Disease)

What Is Alcoholic Cardiomyopathy?

Alcoholic cardiomyopathy is a form of heart disease caused by long-term alcohol abuse.

Over time, alcohol weakens your heart muscle. It can stretch your heart, making it bigger and weaker. This means it can't pump blood as efficiently and reduces oxygen throughout your body.

Who Does it Affect?

Men between 35 and 50 are most at risk of developing alcoholic cardiomyopathy. Women can also develop this form of heart disease, but it is less common.

Most people who develop alcoholic cardiomyopathy have a history (five to 15 years) of heavy drinking.

Heavy drinking is defined as:

• Men: four drinks a day or more than 14 drinks each week
• Women: three drinks a day or more than seven drinks each week

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Causes of Alcohol Cardiomyopathy

The main cause of alcohol cardiomyopathy is chronic alcohol abuse. Alcohol dependence often forms due to chronic alcohol abuse.

Alcohol abuse and dependency are both considered alcohol use disorder (AUD).

Dependence is characterized by uncontrollable drinking patterns and a strong urge to drink alcohol. This stage of alcohol misuse is when tolerance develops and serious withdrawal symptoms can occur.

Alcohol has a toxic effect on many of your organs, such as the liver and heart.

Long-term alcohol abuse can damage your heart muscle over time. This makes it difficult for your heart to pump blood properly, causing it to enlarge and thin out.

Alcoholic cardiomyopathy is diagnosed when the heart muscle and surrounding blood vessels stop functioning correctly.

Symptoms of Alcoholic Cardiomyopathy

The symptoms of alcoholic cardiomyopathy appear differently for everyone. Some people don't have any symptoms during early stages. Others may develop severe symptoms.

The primary indicators of advanced alcoholic cardiomyopathy include:

• Difficulty breathing, especially while exercising
• Shortness of breath, typically during sleep, causing you to wake up frequently
• Heart palpitations
• Poor appetite 
• Irregular or fast heart rate
• A persistent cough that produces a pink mucus
• Problems with urination
• Fatigue
• Muscle weakness
• Dizziness
• Swollen feet, ankles, or legs
• Memory issues
• Trouble focusing on daily tasks
• Weight Gain

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Risk Factors of Alcoholic Cardiomyopathy

If alcoholic cardiomyopathy is left untreated or becomes advanced, heart failure can occur.

Heart failure happens when the heart muscle becomes too weak and stops pumping blood normally.

Other risk factors associated with advanced alcoholic cardiomyopathy include:

• Heart attacks
• Leaking heart valves
• Blood clots
• Extremely high blood pressure
• An enlarged heart
• Atrial fibrillation (irregular heartbeat)
• Stroke
• Blood clots
• Arrhythmia, a less severe form of irregular heart rhythm
• Death

Outlook, Diagnosis & Treatment Options

The outlook for someone with alcoholic cardiomyopathy depends on:

• How long they abused alcohol
• Their age
• The stage of the condition

If the heart is severely damaged, the chances of a full recovery are low. If the disease is caught early, stopping alcohol use completely and taking certain medications can help restore the heart’s function. 

Diagnosing Alcoholic Cardiomyopathy

To diagnose alcoholic cardiomyopathy, there are a few types of imaging tests that may take place.

These include:

• Chest x-rays
• CT scan
• Echocardiogram (uses sound waves to take photos of your heart).
• Electrocardiogram (EKG) to check the electrical signals of your heartbeat

After the diagnosis, treatment is next.

Alcoholic cardiomyopathy treatment may include medications, surgery, or a combination.

Depending on the severity of the condition, your doctor may suggest:

• Eating a healthier diet (less saturated and trans fat) to improve cardiac function.
• Stopping alcohol use altogether.
• Taking certain medications, such as diuretics, ACE inhibitors, and beta-blockers to reduce heart strain. 
• Heart surgery or a heart transplant, depending on the stage of the condition and whether the patient can undergo surgery

Up to 42 percent of people who keep drinking alcohol after being diagnosed with alcoholic cardiomyopathy will likely die within three years.

However, the disease may be reversible if the individual stops drinking alcohol altogether. 

Within just six months of stopping alcohol use, the patient may notice an improvement in their heart function and overall health. Within 18 months of abstinence, a complete recovery is likely to occur.