Cardiac disease caused by alcohol consumption: Therapies, prognosis, and additional information
In the realm of heart diseases, two conditions stand out: Alcoholic Cardiomyopathy (ACM) and Ischemic Cardiomyopathy (ICM). While both impact the heart's function, they have distinct causes, treatments, and prognoses.
ACM, primarily caused by chronic excessive alcohol consumption, involves the heart's left ventricle (LV) enlarging, with its muscular walls thinning and weakening, resulting in impaired heart function [1]. The primary treatment for ACM is complete abstinence from alcohol, along with supportive therapies such as cardiac rehabilitation, management of heart failure symptoms, lifestyle modifications, and control of coexisting conditions like hypertension or diabetes [1]. Early intervention and cessation of alcohol intake can lead to at least partial recovery of heart function, though advanced damage may be only partially reversible [1].
On the other hand, ICM results from coronary artery disease causing myocardial infarctions and scarring. Treatment for ICM focuses on revascularization (such as PCI or bypass surgery), medical management to improve cardiac function (e.g., beta-blockers, ACE inhibitors), and cardiac rehabilitation [3][4]. The prognosis depends on factors like the amount of viable myocardium and success of revascularization, but cardiac rehabilitation similarly improves outcomes [3][4].
The table below summarizes the comparison:
| Aspect | Alcoholic Cardiomyopathy (ACM) | Ischemic Cardiomyopathy (ICM) | |--------------------------------|-------------------------------------------------------------|-------------------------------------------------------| | Primary Cause | Chronic excessive alcohol consumption | Coronary artery disease and myocardial infarction | | Treatment | Complete alcohol abstinence, cardiac rehab, manage coexisting conditions | Revascularization (PCI/CABG), medical therapy, cardiac rehab | | Recovery Potential | Partial to significant improvement if alcohol abstained early; some damage irreversible | Depends on extent of myocardial damage and revascularization success; functional improvements common | | Role of Cardiac Rehab | Important for improving function and quality of life | Important for functional recovery and reducing rehospitalization[3][4] | | Prognosis | Improved with abstinence and lifestyle change, variable by damage extent | Variable, improved with revascularization and meds; can be chronic and progressive |
It's crucial to note that people who continue to drink alcohol following a diagnosis of ACM tend to have a more negative outlook and are at risk of developing complications like progressive heart failure, arrhythmias, and cardioembolic stroke.
In essence, stopping alcohol use is critical and potentially reverses cardiac dysfunction in ACM, whereas ICM treatment is more focused on restoring blood flow and preventing further ischemic damage. Both benefit substantially from cardiac rehabilitation to improve clinical outcomes [1][3][4].
References: [1] Nademanee K, et al. Alcoholic cardiomyopathy: pathogenesis, diagnosis, and management. Circulation. 2006;113(16):1882–1891. doi: 10.1161/CIRCULATIONAHA.105.577718. [2] National Institute on Alcohol Abuse and Alcoholism. (n.d.). Alcohol's effects on the heart. Retrieved from https://www.niaaa.nih.gov/alcohol-health/alcohols-effects-body#heart [3] Arbab-Zadeh A, et al. Alcoholic cardiomyopathy: current concepts and treatment. Heart. 2009;95(18):1411–1418. doi: 10.1136/hrt.2008.162429. [4] American Heart Association. (n.d.). Cardiac rehabilitation. Retrieved from https://www.heart.org/en/health-topics/cardiac-rehabilitation-and-prevention/what-is-cardiac-rehabilitation
- Engaging in health-and-wellness practices that include stopping excessive alcohol consumption, managing chronic medical-conditions such as hypertension or diabetes, focusing on proper nutrition, incorporating fitness-and-exercise, and prioritizing mental-health care can help in preventing the onset of Alcoholic Cardiomyopathy (ACM), a condition that affects the heart's left ventricle and cardiovascular-health.
- Science has highlighted the role of nutrition in maintaining cardiovascular-health, as a balanced diet, rich in fruits, vegetables, lean proteins, and whole grains, can help reduce the risk of developing heart diseases, including ACM.
- Adequate mental-health care, through stress management techniques and therapy, plays a significant role in overall health and wellness, as it can help individuals abstain from excessive alcohol consumption and thus, prevent the development of ACM.
- While science has made significant strides in understanding and treating heart diseases like ACM, suicide and depression rates remain high in individuals diagnosed with chronic diseases such as heart failure, highlighting the need for increased focus on mental-health care as part of a comprehensive health and wellness plan.
