This activity describes the pathophysiology of ACM, its causes, presentation and the role of the interprofessional team in its management.ACM is characterized by increased left ventricular mass, dilatation of alcoholic cardiomyopathy symptoms the left ventricle, and heart failure (both systolic and diastolic). This activity examines when this condition should be considered on differential diagnosis. This activity highlights the role of the interprofessional team in caring for patients with this condition. The treatment of episodes of heart failure in ACM does not differ from that performed in idiopathic-dilated CMP 52,54. A decrease in cardiac preload with diuretics and postload with angiotensin-converting-enzyme inhibitors or beta blockage agents allows for an improvement in signs of acute heart failure 19,131.

Quantity of Alcohol Intake in Cardiac Disease

Moreover, there is a decrease in the left ventricular mass index and ejection fraction, falling below the normal range. Diastolic dysfunction, characterized by impaired left ventricular relaxation and reduced diastolic filling capacity, serves as an early indicator of ACM. Ventricular dilatation is the first echocardiographic change seen in alcohol use disorder patients, coming before diastolic dysfunction and hypertrophy. The symptoms of left ventricular diastolic function included waking up at night with shortness of breath, irregular heartbeat, extreme fatigue and weakness, dizziness and fainting, bouts of chest pain, and swelling in the feet, ankles, and abdomen 13. Evidence of altered bioenergetics or mitochondrial dysfunction has been observed in various investigations of ethanol effect on the heart.

Ways to stay healthy

Frequently, a relative decrease occurs in systolic blood pressure because of reduced cardiac output and increased diastolic blood pressure due to peripheral vasoconstriction, resulting in a decrease in the pulse pressure. Ask any patient presenting with new heart failure of unclear etiology about their alcohol history, with attention to daily, maximal, and lifetime intake and the duration of that intake. The primary treatment for ACM involves complete abstinence from alcohol or other drugs.

Alcoholic cardiomyopathy: Cytotoxicity of alcohol on heart muscle

Alcohol can cause abnormalities in the blood cells in several ways, including nutritional deficiency, marrow toxicity, and liver disease. We conducted our analysis on discharge data from the Healthcare Cost and Utilization Project‐Nationwide Inpatient Sample (HCUP‐NIS) from 2002 through 2014. We obtained data from patients aged ≥18 years with diagnosis of “Alcoholic Cardiomyopathy.” Death was defined within the NIS as in‐hospital mortality. By using International Classification of Disease‐9th edition‐Clinical Modification (ICD‐9CM) diagnoses and diagnosis‐related groups different comorbidities were identified. In the study by Gavazzi et al10, ACM patients who continued drinking exhibited worse transplant-free survival rates after 7 years than those who stopped drinking alcohol (27% vs 45%)10.

• Ethanol-induced disruption of ribosomal protein synthesis also contributes to non-contractile protein depletion 104.
• In experimental studies, acetaldehyde directly impairs cardiac contractile function 76, disrupts cardiac excitation–contraction coupling, and promotes oxidative damage and lipid peroxidation 20.
• At present ACM is considered a specific disease both by the European Society of Cardiology (ESC) and by the American Heart Association (AHA)18,19.
• Subendocardial and interstitial fibrosis progressively appear in the course of ACM, usually in advanced stages 52,56.
• One is the physical characteristics of ethanol itself, with a low molecular size, high distribution capacity, and high tissue reactivity.

TREATMENT

One of the characteristics that makes ethanol harmful is its systemic toxic effect on the human body 10,11. It has been described as having some kind of effect in all human body organs either in acute or chronic consumption 11,12. The liver is the most affected organ, since ethanol is mostly metabolized there 11,13, but gastrointestinal, central, and peripheral nervous systems; the heart and vascular system; endocrinological systems; nutrition; and musculo-skeletal systems are clearly affected 10. In addition, ethanol is an immunosuppressive drug that is pro-inflammatory and pro-oncogenic 14,15,16,17.

• Previous studies were conducted on rats that are fed alcohol for about eight months.
• This observation led to the erroneous belief that alcohol is an immediate coronary vasodilator.
• We identified main themes and sub-themes to provide a comprehensive overview of the current state of knowledge regarding ACM.
• 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 death71.
• Data suggests patients with successful quitting of alcohol have improved overall outcomes with a reduced number of inpatient admissions and improvement in diameter size on echocardiogram.