Cardiomyopathy Symptoms and causes
Clinical Review BoardAll Healthwise education is reviewed by a team that includes physicians, nurses, advanced practitioners, registered dieticians, and other healthcare professionals. Chest radiographs usually show evidence of cardiac enlargement, pulmonary congestion, and pleural effusions. The NIAAA provides an Alcohol Treatment Navigator, where people can learn about AUD treatments and access care and support networks locally. Alcoholic cardiomyopathy is best managed with an interprofessional approach with the involvement of primary care physician and cardiology.
6. The Effect of Low-dose Ethanol on ACM
These stories may not be used to promote or endorse a commercial product or service. Brown-Thomas spent a couple of days in the hospital before leaving with a handful of prescriptions and wearing a defibrillator vest that monitored her heart and could shock it into a normal heart rhythm if needed. Then again, she did have difficulty breathing while lying in bed; she just didn’t connect that to her heart. Brown-Thomas thought she probably needed to slow down because as the daughter of a cultural icon and president of the family foundation, she stayed in high demand. She also had been under a lot of stress dealing with lawsuits over her father’s estate, which weren’t settled until 2021, nearly a year after the episode that sent her to the emergency room. Co-authors on this study included Hanumakumar Bogireddi and Briana Thomas from Cincinnati Children’s and six researchers at the University of Chicago.
Epidemiology and Natural History of DCM
Occidental Berberi is the term used for the clinical scenario caused by thiamine deficit, a situation commonly present in chronic alcohol misuse, and was attributed as the cause of ACM [68,69]. Similarly, electrolyte (Na, K, Ca, Mg, P) deficiencies or disturbances may play a major role in cardiac function, and ethanol misuse may be related to them [52]. Selenium deficit (Keshan disease in China) could also induce ACM in specific areas [70]. This ethanol misuse at high consumption rates causes a variety of health problems, ethanol being the sixth most relevant factor of global burden of disease and responsible for 5.3% of all deaths [5]. Despite this clear epidemiological evidence of ethanol’s unsafe consumption and increased health risk, results of consumption policies are not effective enough. Therefore, the need to establish a more effective control on ethanol consumption has been repeatedly claimed [2].
Study Challenges Current Thinking About Mechanisms of Dilated Cardiomyopathy
Regarding ICD and CRT implantation, the same criteria as in DCM are used in ACM, although it is known that excessive alcohol intake is specifically linked to ventricular arrhythmia and sudden cardiac death[71]. As it is not uncommon in ACM for patients to experience a significant recovery alcoholic cardiomyopathy of systolic function, it is particularly challenging in this disease to decide the most appropriate time to implant an ICD and whether it is necessary to replace a previously implanted device. Future studies in ACM should also address this topic, which has important economic consequences.
- Although several studies have suggested that the clinical outcome of ACM could be improved if patients abstain from alcohol (8,9,21,26), other studies have shown that complete alcohol abstinence may not be necessary to improve LVEF (13).
- Lower blood pressure values often can be tolerated, but orthostasis needs to be avoided.
- Ventricular arrhythmias, including frequent premature ventricular complexes, can also induce cardiomyopathy.
- According to the NIAAA, many people with AUD recover, although setbacks are common among those receiving treatment.
However, they can help you manage your symptoms and slow down the disease’s progression. Your healthcare provider may recommend lifestyle changes, medications, devices or procedures. They’ll decide your treatment based on which type of cardiomyopathy you have and how advanced it is.
- Several studies examined treatment with β-blockers or ACE inhibitors117,151,152 for secondary prevention in high-risk patients after anthracycline treatment.
- The risk of acute manifestations of doxorubicin cardiotoxicity in pediatric patients can be as great as or lower than in adults.
- The signs and symptoms of alcoholic cardiomyopathy (ACM) can vary depending on the severity of the condition.[6] In the early stages, people with ACM may not experience any symptoms.
- Measuring blood alcohol concentration in an acute intoxication gives baseline information but does not permit deductions to chronic misuse.
- Structurally, hypertrophy of myocytes is seen in the early stages to avoid contractile depression [52,107,125].
- According to recent data, a genetic form of DCM could be present in up to 50% of idiopathic DCM cases, and other specific forms of DCM such as peripartum cardiomyopathy have been shown to have a genetic basis in a significant number of cases[68].
In Munich, the annual consumption of beer reached 245 l per capita and year in the last quarter of the 19th century. In 1884, the pathologist and veterinarian Otto von Bollinger (Fig. 2a) described the “Munich beer heart” with fibrosis, hypertrophy, and fatty degeneration in postmortem cardiac tissue of alcoholics who consumed an estimated average of 432 liters of beer per year (Fig. 2b; [23]). At that time every 10th necropsy in men at the Munich pathology institute named cardiac dilatation and fatty degeneration as “Bierherz” being its underlying cause.
Survival is significantly lower for patients who continue to drink than for patients with idiopathic DCM or for patients with alcoholic cardiomyopathy who abstain from drinking. Because patients with chronic alcoholism could be prone to thiamine deficiency, which can result in or contribute to the development of cardiomyopathy, it is critical to supplement thiamine and folate in these patients. Counseling and resource provision for patients should be part of management. Symptomatic management in people with secondary heart failure to address any related consequences is also vital in managing ACM. According to several articles, even moderate alcohol use has comparable effects to abstinence.
Natural History and Prognostic Factors in Alcoholic CardiomyopathyFree Access
In some cases, ACM can cause arrhythmias or irregular heartbeats, which can be life-threatening. Therefore, complete abstinence from ethanol is the most useful measure to control the natural course of ACM [51,56,135]. In fact, patients with ACM who abstain from alcohol have a better long-term prognosis than subjects with idiopathic dilated CMP [54]. Out of end-stage cases, the majority of subjects affected by ACM who achieve complete ethanol abstinence functionally improve [33,82,135].
- Prior radiotherapy to the heart/mediastinum also increases the risk of doxorubicin-induced cardiomyopathy.
- Long-term alcohol abuse weakens and thins the heart muscle, affecting its ability to pump blood.
- Athletes, especially those who follow intense training regimens, may develop changes in cardiac structure as a normal physiologic response.
- Excessive EtOH consumption is one of the main causes of non-ischemic dilated cardiomyopathy (CMP), representing around one-third of cases [30].
