Alcoholic Cardiomyopathy: Causes, Symptoms, and Diagnosis

In a subsequent study using electron microscopy, the authors found histological features that could be superimposed onto those found in hearts that had suffered hypoxia, anoxia or ischemia[43]. Analogous to the sarcoplasmic reticulum, the mitochondria were swollen or oedema was present, with crest alterations and intra-mitochondrial inclusions suggesting degenerative processes (Figure ​(Figure2).2). Moreover, myofibrils showed a progressively distorted structure, resulting in a homogeneous mass. A second set of studies that are quoted when addressing this topic are those conducted in individuals who started an alcohol withdrawal program[21-24]. In these studies, the authors estimated the amount and chronicity of alcohol intake and subsequently related the figures to a number of echocardiographic measurements and parameters. Although all of the studies reported an increase in left ventricular mass and volume, it cannot generally be stated that they provided the alcohol consumption dosage required to cause ACM.

Differential Diagnosis

Eventually, the heart muscle and blood vessels may stop functioning properly due to the damage and strain. The beneficial heart wine as universal remedy in medieval ages by Hildegard von Bingen [11] found its later correlates in many observations at the beginning of modern medicine when coronary artery disease (CAD) and its risk factors and symptoms received more attention. Heberden [89] described angina so elegantly in 1786 and also added that ”considerable relief“ through ”wine and spirituous liquors“ could be expected.

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It was characterized by congestive heart failure, pericardial effusion, and an elevated hemoglobin concentration. The explanation proved to be the addition of small amounts of cobalt chloride. Cobalt was used as a foam stabilizer by certain alcoholic cardiomyopathy breweries in Canada and in the USA. Cobalt poisoning and alcohol together acted synergistically in these patients. As the syndrome could be attributed to the toxicity of this trace element, the additive was prohibited thereafter.

• Some people may drink alcohol to the point that it causes problems, but they’re not physically dependent on alcohol.
• Patients with alcoholic cardiomyopathy, therefore, usually present with symptoms of heart failure, i.
• They found that there is about 14% loss of myocardial cells in the left ventricle of those rats.

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One of the few papers analysing genetic susceptibility in ACM was published by Fernández-Solà et al[64] in 2002. He compared the prevalence of different polymorphisms of the angiotensin-converting enzyme gene in 30 https://ecosoberhouse.com/ ACM patients and in 27 alcoholics with normal ventricular function. Furthermore, 89% of the alcoholics with a DD genotype developed ACM, whereas only 13% of those with an II or ID genotype developed this condition.

• Ethanol is one of the most addictive drugs for humans, with high physical and psychological addiction potential [7].
• Furthermore, they specified the definition of “one drink” offer clarity when it comes to alcohol consumption.
• Therefore, because of its multiple actions, acetaldehyde may influence ACM pathogenesis in addition to ethanol effect itself [20,76,77].
• One of the characteristics that makes ethanol harmful is its systemic toxic effect on the human body [10,11].

Females constitute roughly 14 % of cases of alcohol induced cardiomyopathy however lifetime exposure required for women to develop alcohol induced cardiomyopathy is less compared to men. Dilated cardiomyopathy secondary to alcohol use does not have a pre-defined exposure time. Daily alcohol consumption of 80 g per day or more for more than 5 years significantly increases the risk, however not all chronic alcohol users will develop Alcohol-induced cardiomyopathy. Alcohol-induced cardiomyopathy, especially when more severe, leads to deadly problems like heart attack, stroke or heart failure. Individuals with this condition who don’t stop drinking heavily are at the greatest risk. Between 40% to 80% of people who continue to drink heavily will not survive more than 10 years after receiving this diagnosis.

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6. Cardiac Hypertrophy and Remodeling in ACM

• Both the absence of a direct correlation and the theory of the existence of a threshold dose (above which some alcoholics develop ACM) require the presence of individual susceptibility to alcohol induced cardiac damage[63].
• In cases where people don’t recover fully by abstaining from alcohol, most people will still see noticeable improvements in their symptoms.
• Biomarkers of heart failure such as NT-proBNP and of myocardial necrosis such as the troponins and CKMB indicate heart failure or myocytolysis.
• Finally, we analyzed and presented the synthesized literature, along with relevant findings and conclusions from the included studies, in a coherent manner.
• The effect measure for each outcome was conducted using the mean differences effect measure, where the outcomes were assessed in identical units across the various literature reviews used in the study.