What is Alcoholic Cardiomyopathy?

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  • Written By: Carol Kindle
  • Edited By: Kristen Osborne
  • Last Modified Date: 24 September 2019
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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.


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Post 3

@umbra21 - Not necessarily. I was friends with some guys for a long time who drank fairly heavily on the weekends, but didn't really drink much during the week. And one of them was diagnosed with a bad liver, relating to alcohol. They were all really surprised, because, to them, they weren't anywhere close to being alcoholics and just thought of themselves as normal.

I don't know if that much alcohol can induce cardiomyopathy, but people might be genuinely surprised to find out that they qualify as an alcoholic, with an alcoholic's diseases.

Post 2

@bythewell - The thing is, alcohol abuse needs to be fairly extreme and consistent for a long time in order to bring on alcoholic cardiomyopathy symptoms. Most people will have recognized that there was something wrong a long time before they get to the point where their heart is in danger.

And, frankly, I can see how you might ignore alcoholism for a few years if you've got lots of drinking buddies and no one calls you out on it, but eventually you've got to realize that you're just lying to yourself.

The body isn't meant to keep going in those situations and it will start to react badly. When you wake up and you feel like you want to die from the hangover and you believe the only thing that could possibly make you feel better is another drink, most people will realize that they have a problem, even if they don't want to deal with it.

Post 1

Something that I discovered when I was studying is that you don't always know when you're an alcoholic. It seemed like the kind of thing that would be obvious, but if you are immersed in a drinking culture and it's considered normal to drink to excess regularly, then you could be addicted to alcohol and not even realize it because no one ever lets you know that what you're doing is unhealthy.

If you are never told to stop, then you never find out that you can't stop. And that's what most people think of as the definition of addiction. So, you could be heading towards cardiomyopathy symptoms and not even realize it.

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