Chronic alcohol abuse can affect almost every part of the body. While the liver gets a lot of attention, alcohol and its effect on the heart also need to be taken seriously.

Heavy drinking can weaken the heart and lead to a variety of cardiac conditions including stroke, high blood pressure, arrhythmias, and alcoholic cardiomyopathy. You may be asking “what is alcoholic cardiomyopathy?” since it’s not something you hear about every day.

Cardiomyopathy is a disease of the heart muscle that occurs when the muscle is stiffer or thicker than it should be. When cardiomyopathy develops because of chronic alcohol abuse, it is called alcoholic cardiomyopathy.

When untreated, alcoholic cardiomyopathy can be life-threatening. It can become severe and lead to irregular heartbeat and congestive heart failure. If it is caught early, the outcome is often positive.

However, it is extremely important for people who have alcoholic cardiomyopathy to stop drinking and get treatment for their alcoholism. 

Types of Cardiomyopathy

The stiffening or thickening of the heart muscle can be either acquired or inherited. When cardiomyopathy is acquired, this means it developed because of a condition, another disease, or some other factor. It is not always clear why cardiomyopathy occurs. The main types of cardiomyopathy are:

  • Dilated. This is when one of the ventricles of the heart is enlarged. It is the most common form of cardiomyopathy in children and it’s more likely to occur in males.  Dilated cardiomyopathy can affect people of any age but it occurs most often in middle-aged people. It is usually caused by coronary artery disease or heart attack but it can also be due to genetics. Alcoholic cardiomyopathy is a type of dilated cardiomyopathy.
  • Hypertrophic. This is when the heart muscle thickens. Hypertrophic cardiomyopathy often presents in early adulthood or childhood and it can result in sudden death. It is usually inherited and people who have it may be asymptomatic. If a person has a family history of hypertrophic cardiomyopathy,  they should be tested and they should take steps to reduce their risk of sudden death.
  • Arrhythmogenic. This is when cardiomyopathy causes irregular heartbeats or irregular heart rhythms. This form of the disease is rare and is often inherited. It is most common in males. The muscle in the right ventricle is replaced by scar tissue and this is what leads to the irregularities.
  • Restrictive. This is the least common type of cardiomyopathy. It involves a heart muscle that’s stiff, scarred, or both. It can occur along with amyloidosis ( a buildup of amyloid proteins on the heart, kidney, and liver) or hemochromatosis (excess iron in the body), and other conditions. In restrictive cardiomyopathy, the heart muscle stiffens and becomes less flexible. This prevents it from expanding and filling with blood between heartbeats. This type of cardiomyopathy can occur at any age, but it is most common in older people.

Risk Factors for Cardiomyopathy

Risk Factors for Cardiomyopathy

Several things can increase an individual’s risk of developing cardiomyopathy. These include:

  • Chronic high blood pressure
  • A family history of sudden cardiac arrest, heart failure, and cardiomyopathy
  • Obesity
  • A previous infection of the heart, heart attack, or coronary artery disease
  • Long-term alcohol abuse
  • Use of amphetamines, cocaine, and anabolic steroid
  • Radiation treatment and certain chemotherapy drugs

Diseases that may play a role include:

  • Thyroid disease
  • Diabetes
  • Sarcoidosis
  • Connective tissue disorders

What Causes Alcoholic Cardiomyopathy?

Alcoholic cardiomyopathy develops as a result of heavy and usually chronic alcohol abuse. Over time, excessive drinking weakens the heart muscles and impairs their ability to pump blood.

When the heart is finding it difficult to pump normally, the blood stays in the left and right ventricles, and the heart thins out and expands to accommodate the blood. Once the heart becomes enlarged, it can cause severe damage, and ultimately, heart failure.

Who Is at Risk for Alcoholic Cardiomyopathy?

Alcoholic cardiomyopathy is most likely to occur in middle-aged adults who have been abusing alcohol for several years or even decades. Researchers say drinking alcohol every day for at least five years can significantly increase an individual’s risk of developing this disease.

However, it is not clear how much alcohol and how many years of drinking are required for alcoholic cardiomyopathy to develop.

Many chronic abusers of alcohol develop physical dependence and high tolerance. This means they often drink more and more to avoid going into withdrawal. This can result in heavy drinking every day.

The United States Centers for Disease Control define heavy drinking as more than 15 drinks per week for men and more than eight drinks per week for women. 

What’s considered a drink? Based on the Dietary Guidelines for Healthy Americans 2015-2020, a standard drink is a shot of distilled spirits, a 12-ounce beer, or a five-ounce glass of wine.

However, even smaller amounts of alcohol can be harmful depending on the characteristics of the individual such as size, age, and medical condition. Therefore, what causes heart damage in one person may not cause it in another.

Symptoms and Signs Of Alcoholic Cardiomyopathy

Sometimes people don’t know they have alcoholic cardiomyopathy until the disease has advanced considerably. While there are many tests that can be used to assess heart function, people with alcohol dependence often don’t see their doctor regularly.

If they’re not experiencing any symptoms or they don’t know the symptoms of cardiomyopathy, they may not know how their drinking is damaging their heart.

When symptoms present, they are similar to those of congestive heart failure. They include:

  • Dizziness
  • Shortness of breath
  • Chest pain
  • Loss of appetite
  • Coughing up pink mucus
  • Swelling of the abdomen, arms, legs, or feet
  • Weakness or fatigue
  • More frequent or less frequent urination

Diagnosing Alcoholic Cardiomyopathy

If you or someone you love is showing signs of alcoholic cardiomyopathy, you need to see a doctor immediately. If a person sees a doctor and reports symptoms associated with alcoholic cardiomyopathy, the doctor will check their blood pressure, pulse, lungs, and heart.

They will be looking for signs of an enlarged heart, heart murmur, lung or heart congestion, swelling of the jugular veins, and swelling of the legs, ankles, and feet.

The doctor will ask about your medical history and your history of alcohol consumption. It is important that you tell the truth about how much alcohol you drink each day and how long you’ve been drinking heavily. This will help the doctor to arrive at a diagnosis and come up with a treatment plan. 

The doctor may also request laboratory tests and imaging. While lab tests won’t specifically show up alcoholic cardiomyopathy, they can help to reveal damage to the heart and other organs.

For example, a blood chemistry panel will measure the levels of some substances in the blood. Meanwhile, a liver function test can reveal liver damage and inflammation.

 X-ray and CT scans can detect an enlarged heart as well as congestion or fluid in the lungs. An echocardiogram may show an enlarged heart, blood clots, leaking heart valves, and high blood pressure. Meanwhile, an electrocardiogram will show if you have an irregular heartbeat.

You may be asked to undergo a treadmill stress test. This involves walking on a treadmill while the doctor monitors your breathing, heart rhythm, and blood pressure. This will help the physician to evaluate your symptoms and determine if physical exertion triggers abnormal heart rhythms.

Another procedure that you may undergo is cardiac catheterization. This is when a catheter is inserted into the groin and guided through your blood vessels to your heart.

This allows the doctor to measure the pressure in heart chambers and determine how forcefully the blood is pumping. Cardiac catheterization can show up blockages in the blood vessels.

How Dangerous Is Alcoholic Cardiomyopathy?

Not everyone who abuses alcohol will develop this illness. However, when it does occur, it needs to be taken seriously. When the heart is weak, it won’t function as it should and without treatment, it may eventually stop functioning.

People who have alcoholic cardiomyopathy may experience blood clots in the heart, problems with the heart valves, irregular heartbeat, and heart failure. One study found that more than a quarter of patients hospitalized for alcoholic cardiomyopathy died within two to six years after they were in the hospital.

Can Alcoholic Cardiomyopathy Be Reversed?

Alcoholic cardiomyopathy isn’t automatically a death sentence. If it is caught in the early stages and the patient stops drinking and seeks treatment, it can be completely reversed.

In some cases, six months of abstinence from alcohol brings about improves function in the left ventricle. After 18 months, the patient can recover completely.

However, the longer a person has been drinking, the less likely is it that they will have a positive outcome. And, if they continue to drink after the disease sets in, the outcome is likely to be poor. Research shows that 42 percent of people who continue to drink regularly after their diagnoses die within three years.

Advanced cases of alcoholic cardiomyopathy are unlikely to be reversed. However, they may be managed and the progression of the disease can be halted by abstaining from alcohol. 

Treatment for Alcoholic Cardiomyopathy

Treatment for Alcoholic Cardiomyopathy

Alcoholic cardiomyopathy treatment can take several different forms depending on the severity of the disease and the individual’s overall health.

It may require a low-sodium diet, medications, the installation of a defibrillator or pacemaker, or even a heart transplant. Let’s take a closer look at some of these treatment options.


Naturally, the medication a person is prescribed depends on their symptoms. ACE inhibitors may be prescribed to relax the blood vessels and lower blood pressure while anticoagulants are used to dissolve any existing blood clots or prevent the formation of clots.

Meanwhile, beta-blockers reduce blood pressure and manage abnormal heart rhythms. Diuretics may also be prescribed to people with alcoholic cardiomyopathy. They help the body to get rid of unneeded water and salt and this makes it easier for the heart to pump blood. It also controls blood pressure. 

Nonsurgical Procedures

A number of procedures can be used to treat cardiomyopathy including septal ablation and radiofrequency ablation. Septal ablation is when a small part of the thickened heart muscle is destroyed by injecting alcohol into the artery supplying the area with blood.

This allows blood to reach the area. Meanwhile, radiofrequency ablation is a procedure used to treat irregular heart rhythms. Catheters with electrodes at the tips are guided through the blood vessels to the heart. They transmit energy that damages a small part of the heart tissue that is causing the irregularity.

Surgically Implanted Devices

Some cases of alcoholic cardiomyopathy require the implantation of a device to relieve symptoms and improve heart function. Pacemakers are placed under the skin in the abdomen or the chest and they deliver electrical impulses to control arrhythmias.

Meanwhile, implantable cardioverter-defibrillators (ICDs) monitor heart rhythm and deliver electric shocks when necessary. ICDs don’t treat cardiomyopathy but they identify and control abnormal rhythms.

Ventricular assist devices (VADs) are used to improve blood flow through the heart. They may be implanted if less invasive approaches don’t work. VADs can be used for the long term or as a short-term intervention while the patient awaits a heart transplant. If a person is in end-stage heart failure and other treatments aren’t work, doctors may recommend a heart transplant. 


Another important step in managing alcoholic cardiomyopathy is quitting drinking. The other intervention won’t be very helpful if the individual continues to drink. Quitting alcohol is often very difficult for people who are dependent on or addicted to alcohol.

Even when it’s clear that their drinking is making them ill, they may still be averse to reducing or stopping their alcohol consumption. Many people benefit most from entering an addiction treatment facility that offers medically supervised detox followed by personalized, evidence-based rehabilitation.

How To Prevent Alcoholic Cardiomyopathy

If you are genetically predisposed to cardiomyopathy you may not be able to stop yourself from developing it. However, by decreasing your alcohol intake, you can reduce the risk of complications such as blood clots, cardiac arrest, and heart valve problems.

If you aren’t aware of a genetic predisposition, you can avoid alcoholic cardiomyopathy by moderating your use of alcohol. If you believe your alcohol use has become problematic, you should seek treatment at the earliest opportunity to reduce damage to your organs.

Some people believe alcohol has health benefits. While some research shows that drinking red wine may reduce the risk of heart disease, the American Heart Association said there’s no definitive link. The AHA points out that any benefits that may be derived from red wine can be obtained from other sources such as grape juice.

You can also prevent cardiomyopathy by exercising regularly, reducing your stress levels, eating a healthy diet, getting enough sleep. If you have diabetes, high cholesterol, or hypertension, you should keep it under control.

Fight Alcoholic Cardiomyopathy by Treating Alcoholism

Fight Alcoholic Cardiomyopathy by Treating Alcoholism

If you’re abusing alcohol, your health will be affected. If you’re experiencing symptoms of cardiomyopathy or you’ve already received such a diagnosis, you need to work on your substance use problems. The first step is to undergo medically supervised detox. 

While some people who are addicted to alcohol try to detox at home, this can be highly uncomfortable and even life-threatening. Medical supervision is especially important if you have co-occurring mental health problems or a physical condition such as a heart problem. Constant medical supervision, medication, and psychological support can make the process safer and more comfortable.

After detox, the next step is to undergo therapy and counseling. This is extremely important since detox alone is not enough to ensure long-term sobriety. In therapy, you’ll learn how to manage stress, triggers, and cravings and avoid relapse.

Depending on the severity of your addiction, you may start with inpatient treatment and then step down to less intensive forms of treatment. People who are in recovery from addiction usually need ongoing support to maintain their sobriety.

Contact Pathfinders Recovery Center Today to Learn More

At Pathfinders Recovery Center, we offer a full continuum of care for people who are dependent on alcohol. This means we offer inpatient rehab, partial hospitalization programs, intensive outpatient programs, and long-term rehab. We treat each patient as an individual and we take their needs and preferences into consideration.

Through behavioral therapy and other treatments, we help individuals to get to the root of their addictions and develop healthier habits. If you’ve been diagnosed with alcoholic cardiomyopathy or another condition because of your chronic alcohol abuse, you need to seek help.

Recovery from both alcoholism and alcoholic cardiomyopathy is possible but you need to seek professional help in order to be successful. Contact us today to learn more about what we do and how we can help you. 


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