Alcoholic Cardiomyopathy - Causes, Symptoms, Diagnosis, and Treatment

Introduction

Cardiomyopathy is a heart condition that causes malfunctioning of the cardiac muscle called the myocardium, because of the stiffening and the expansion of the heart. The cardiovascular changes will eventually lead to a drastic reduction in the pumping mechanism of the heart, which in turn is a major cause of irregular heartbeats. Cardiomyopathy is a heart disease that intensifies in nature and when it is induced due to heavy alcohol use, it is referred to as alcoholic cardiomyopathy. The immediate aftermath of this is the weakening of the heart and related structures, reduced blood supply throughout the body, and failure to maintain a normal and steady electrical rhythm. Diagnosis is supported through an electrocardiogram or echocardiogram. With time, diagnosed individuals will start showing signs of severe fatigue as well as shortness of breath that will ultimately lead to failure of both sides of the heart. The initial line of treatment and management is towards symptomatic relief that is presented by the diagnosed patient. Further management may be sorted with the aid of several other available kinds of treatment modalities that include cardiac resynchronization therapy, implantable cardioverter, defibrillator, and pharmacological management. Certain complications of untreated alcoholic cardiomyopathy may include heart failure, valvular heart disease, and an irregular heartbeat.

What Are Signs and Symptoms of Alcoholic Cardiomyopathy?

In the initial stages of the condition, alcoholic cardiomyopathy can be asymptomatic. Then, symptoms start to appear as the disease progresses over time. Nevertheless, many individuals do experience the below-mentioned signs and symptoms at the very beginning of the development of the condition.

• Shortness of breath.

• Decreased ability of physical activities.

• Swelling of the legs and feet.

• Fluid retention.

• Swelling in the abdomen.

• Palpitations.

• Lightheadedness.

• Myocardial thickening.

• Defects in impulse activities.

• Abnormal electrical conduction.

• Enlargement of the cavities of the heart.

• Episodes of clot formation in the heart.

• Fluctuations in blood pressure.

• Fatigue.

• Pain or discomfort in the chest.

• Pounding or fluttering feeling in the chest.

• Dizziness.

• Syncope (fainting).

• Persistent cough.

• Angina.

• Loss of appetite.

• Generalized edema and swelling of the body.

• Decreased levels of concentration.

• Altered behavior.

• No sense of alertness.

• Oliguria or decreased urine output.

• Frequent trips to the restroom at night.

What Are Causes of Alcoholic Cardiomyopathy?

Alcoholic cardiomyopathy, as the name suggests, is because by an increase in indulging alcohol and overuse of alcohol. People who suffer from this condition generally have a drinking disorder and do not have self-control over alcoholic beverages. Heavy drinking is associated with numerous adverse outcomes on the cardiovascular system. Excessive intake of alcohol may lead to an array of heart disorders, such as cardiac arrest, reduced cardiac output, heart failure, and even stroke. Too much alcohol affects the muscles of the heart and leads to cardiac muscle malfunctioning, called cardiomyopathy. Alcohol can also contribute to obesity. The list of diseases associated with alcohol is long. Alcohol has been studied to have a solid potential to completely disrupt the cardiovascular system. The toxins of alcohol directly come in contact with the heart and, in the long run, lead to cardiovascular diseases such as alcoholic cardiomyopathy and heart failure.

How to Diagnose Alcoholic Cardiomyopathy?

Several diagnostic measures are available to investigate the heart condition of a patient and identify abnormalities such as alcoholic cardiomyopathy. A comprehensive cardiac investigation, in addition to history documentation, is vital to diagnose any complication related to the cardiovascular system. Patients are suggested to provide an honest history about their indulgence, addiction, and frequency of alcohol use since this will aid the healthcare provider in reaching the correct diagnosis in a shorter span of time and will eventually support the patient’s health by being able to draw a positive and quick line of treatment and management. Mentioned below are a few of the diagnostic tools used to determine the presence of alcoholic cardiomyopathy.

• Chest X-rays to compare the heart size as well as other cardiac structures.

• Electrocardiogram to record the heart’s electrical activity.

• Echocardiogram to assess the functioning of the heart muscles.

• Transesophageal echo or TEE to provide the posterior angle of the heart.

• A stress test aims to evaluate the heart during strenuous activities.

• Doppler imaging.

• Myocardial biopsy.

• Genetic testing in case there is a family history of cardiovascular conditions.

• Positron imaging tomography or PET scan.

• Magnetic resonance imaging.

• Myocardial scintigraphy or nuclear sensitivity test.

• Cardiac catheterization.

What Are the Complications of Alcoholic Cardiomyopathy?

Alcoholic cardiomyopathy is a cardiovascular condition that results in abnormal conduction of the heart as well as a malfunctioning of the pumping mechanism of the heart because of the effects of alcoholic toxins. Alcoholic cardiomyopathy requires correct diagnosis, in addition to prompt treatment, in order to avoid the possible below-mentioned complications.

• Since the pumping mechanism of the heart fails, the heart will eventually stop working.

• Easy formation of blood clots.

• Enlargement of the heart in size.

• Valvular heart disease (a condition in which there are abnormalities or malfunctions in one or more of the heart's valves).

• The incompetence of the heart valves, especially the mitral valve and tricuspid valve.

• The abnormal rhythm of the heart.

• Dilated cardiomyopathy.

• Cardiac arrest.

• Spot death.

What Are the Treatment Options for Alcoholic Cardiomyopathy?

Alcoholic cardiomyopathy is due to the excess intake of alcohol. The treatment is step by step, by correcting each and every layer of damage done to the cardiovascular system. Simultaneously, the patient must give up the habit of drinking alcohol or related beverages, or else the treatment is bound to fail. Mentioned below are a few of the treatment options for alcoholic cardiomyopathy.

• Angiotensin-converting enzymes or ACE inhibitors.

• Angiotensin II receptor blockers.

• Beta-blockers.

• Diuretics.

• Blood thinners or anticoagulants.

• Digoxin.

• Implantable loop recorders.

• Pacemaker.

• Implantable cardioverter.

• The last resort is heart transplantation.

Conclusion

Alcoholic cardiomyopathy is a kind of dilated cardiomyopathy that leads to abnormal enlargement of the inner layers of the heart and is caused because of direct contact with alcoholic toxins. Patients who overindulge or are addicted to alcohol, or may even be suffering from alcoholics drinking disorder, must consider psychological and therapeutic help such as AA or alcohol anonymous to ward off alcoholic cardiomyopathy and other alcohol-related disorders.