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Alcoholic Cardiomyopathy And Other Alcohol-Induced Heart Diseases

Last Updated: March 30, 2021

Authored by Nena Messina, Ph.D.

Reviewed by Michael Espelin APRN

Alcohol is the most widely consumed addictive substance in the U.S. Heart disease is America’s most common cause of death. While these may seem like unrelated facts, decades of research point to a clear connection between alcohol and heart disease. Even moderate drinking can lead to significant changes in normal cardiac function. And when consumed in excessive amounts, alcohol can contribute to the onset of problems that include palpitations, alcoholic cardiomyopathy, an elevated heart rate, high blood pressure, heart attacks, and congestive heart failure.

Alcohol and Heart Health

Available research about the effects of alcohol on this organ is conflicting. For the individual, the way these studies measure alcohol consumption varies, so it is hard to compare the points of view that use different methods.

Generally, information about the rate of consumption in such studies is based on self-reports. The quantification of how much should be considered one “drink” is measured between 12 to 15 grams of alcohol content. However, these figures tend to vary between studies, and this variation contributes to the conflicting reports from studies about the relationship between alcohol and heart disease.

While some studies assert it can only be bad for one’s health, others reveal the opposite. However, delving deeper into this research will show that the effects of the substance on heart health are strongly dependent on the amount of alcohol consumed.

Bearing this in mind, one may surmise that moderate drinkers are more likely to experience the benefits of drinking, such as an increase in HDL levels (good cholesterol) in the body. In contrast, heavy drinkers are more likely to experience the side effects of the substance. It is essential to point out that drinking is not the only way to increase the body’s levels of good cholesterol, so it should not be the sole reason for doing it.

To emphasize the impact of the quantity of liquor consumed on the effects of alcohol in the body, it should be admitted that heavy drinkers are more likely to experience heart problems.

A study that backs this up revealed people who had ten or more drinks per week died a year or two earlier than people who consumed about five drinks per week. As the number of drinks consumed per week increases, life expectancy consequently reduces. At 18 or more drinks per week, life expectancy can be cut short by up to four or five years.

Studies have also shown that binge-drinking (5 or more drinks in one sitting) contributes to high blood pressure (HBP) and hypertension risk.

Who Is at Most Risk?

Excessive drinking creates a multitude of health risks. Also, some people are at risk for cardiovascular problems even when they consume alcohol in smaller amounts. Examples of these groups include:

  • People already affected by heart failure
  • People already affected by HBP
  • People with high triglyceride levels
  • People already affected by heartbeat irregularities
  • People with diabetes
  • People with a history of strokes

Anyone that falls within the listed categories may find that typical rules of consuming alcohol in moderation may not apply. These categories of people will have a stronger adverse reaction to having alcohol in the body, and the side effects may be more severe than for regular people. One of the risks that people in these categories are more exposed to include alcoholic cardiomyopathy, discussed in the next section.

Senior male Asian suffering from heart attack.

Alcoholic Cardiomyopathy Overview

This is a form of heart disease that is directly caused by alcohol abuse. Consuming alcohol in higher-than-moderate quantities over a long time puts a lot of strain on the heart muscles, thinning it out and affecting its ability to pump blood.

The result of this inability to pump the required amounts of blood around the body disrupts many bodily functions and can lead to heart failure or other life-threatening conditions.

Alcoholic Cardiomyopathy (ACM) is not gender-specific. It can occur in both men and women, although it is more common in men aged between 35 and 50 that have been abusing alcohol for a period of 5 to 15 years. At this stage, it is essential to emphasize the difference between heavy drinking for men and heavy drinking for women.

For men, taking more than 4 drinks per day or 14 drinks per week is heavy drinking, but women have a lower threshold of more than 3 drinks per day or more than 7 drinks per week. This means that a man may consume up to 9 drinks per week and still have a lower chance of experiencing ACM than a woman that takes 8 drinks per week.

There are Specific Symptoms to Look out for in a Person who is at Risk of Experiencing ACM. They Include:

  • Appetite loss
  • Fatigue
  • Shortness of breath
  • Dizziness
  • Lack of concentration
  • Irregular pulse
  • Swelling of the feet, leg, and ankles
  • Weakness
  • A change in urination habits and output
  • Pink mucus discharge after coughing
  • Chest pain

Alcoholic cardiomyopathy is not a generally applicable endgame for everyone who abuses alcohol, but it is a severe condition for people who experience it. The disease affects a vital organ in the body. Any resultant loss of proper function caused by ACM is likely to lead to various severe medical conditions.

So, how does alcohol affect the heart where ACM is present?

  • Heart failure
  • Blood clots in the heart
  • Irregular heartbeats
  • Heart valve problems
  • Death

As recently as 2018, a study related to ACM was carried out to determine the prognostic factors of alcoholic cardiomyopathy. One of the study findings was a damning statistic that showed up to 27.7% of patients hospitalized for ACM-related conditions died within 2 to 6 years after hospitalization.

This death rate emphasizes the seriousness of the condition and how it can be deadly even after treatment. This can happen if the treatment received was not from a professional or if the exact diagnosis was incorrect. To get the right diagnosis, there should typically be a physical exam and, in some cases, laboratory tests and x-rays.

Physical Exam

For the physical exam, the doctor will check the pulse and blood pressure and then examine the lungs and the heart. These basic starter tests will help the doctor to identify the following ACM signs where they exist:

  • Heart murmurs from valve damage
  • Swelling of jugular veins in the neck
  • An enlarged heart
  • Sounds of congestion in the heart and lungs
  • Swelling of the ankles, legs, and feet

At this stage, the doctor will also ask about the patient’s medical history and drinking habits.

Laboratory Tests

These tests are not precisely for diagnosing ACM but are useful for checking organs to identify the extent of any damage.

Treating Alcoholic Cardiomyopathy

After diagnosis, the next step is treatment. This can be done effectively only if the person stops drinking alcohol completely. The doctor would also recommend that the patient should take diuretics, maintain a low-salt diet and reduce fluid intake to reduce the pressure of fluid retention on the heart.

Additionally, the doctor can prescribe beta-blockers and ACE-inhibitors to help lower blood pressure. If the heart is severely damaged, a pacemaker or an implantable defibrillator is likely to be recommended.

Cardiologist explains alcoholic cardiomyopathy to the patient.

Alcohol and Heart Palpitations

Palpitations occur when the heart skips a beat in its regular rhythm or adds an extra beat. People affected by these abnormalities can experience a racing heartbeat. Additional possible symptoms include a fluttering or pounding sensation located in the chest, throat, or neck.

In a study conducted with 223 patients with cardiac arrhythmia, 133 reported irregular palpitations when drinking or intermittent/paroxysmal atrial fibrillation, and 90 had SVT without any atrial fibrillation.

Most of the time, palpitations are harmless and disappear on their own in a short amount of time. However, they can also indicate the presence of a severe irregularity called atrial fibrillation (AF or Afib).

Afib is the World’s Most Common Form of an Irregular Pulse. In Addition to Palpitations, Symptoms of this Condition Include:

  • Lightheadedness
  • Fatigue
  • Chest pain
  • Shortness of breath

In severe cases, atrial fibrillation can also lead to a life-threatening stroke or pulmonary embolism.

People who consume just one to three standard servings of hard liquor or wine per day can develop atrial fibrillation accompanied by palpitations and additional symptoms. However, moderate beer consumption does not appear to trigger increased Afib risks. When consumed in excessive amounts, all types of alcohol can contribute to the development of the condition. This pattern of consumption can take the form of binge-drinking or ongoing heavy intake.

Episodic or chronic heavy drinking can also lead to another type of heartbeat irregularity called ventricular tachycardia. While Afib affects the upper chambers, this second condition affects the lower chambers. The core symptoms of alcohol-induced ventricular tachycardia mirror the core symptoms of atrial fibrillation. Severe cases of the disease can lead to a complete heart stoppage and death.

Alcohol and Heart Rate

Alcohol is a central nervous system depressant. Among other things, this means that its presence in the bloodstream can slow down the heart. However, the situation is different for people who drink in heavy amounts. This level of consumption can lead to the onset of a specific form of alcohol heart rate called atrial or supraventricular tachycardia (SVT).

SVT occurs when the electrical signals that control the two upper chambers don’t fire at their expected times. The altered timing of these signals leads to a rapid heart rate that exceeds 100 beats per minute. Some people with supraventricular tachycardia experience no apparent symptoms. When symptoms do occur, they often resemble those associated with atrial fibrillation.

Other Potential Indicators of the Condition Include:

  • Fainting spells
  • Loss of consciousness (in severe cases)
  • Cardiac arrest (also in extreme cases)

Can People With Bradycardia Drink Alcohol?

Bradycardia refers to a condition where a person has a slow, steady heartbeat of under 60 beats per minute. Considering the fact that alcohol is known to speed up the rate, there can be a misunderstanding that the substance can serve as a tonic for bradycardia.

Contrary to that opinion, alcohol does not reverse the symptoms of bradycardia. While moderate drinking can be safe, anything more than that can be dangerous for people living with the condition. Binge drinking can lead to atrial fibrillation or, worse, heart failure.

Alcohol and High Blood Pressure

Blood pressure is a term that describes the amount of force placed on the vessels that carry blood from the heart to various parts of the body. When the heart beats, these vessels experience something called systolic pressure. When it rests, they experience something called diastolic pressure. A blood pressure reading combines systolic measurements with diastolic measurements. Cases of high blood pressure (also known as hypertension) can occur as a result of high systolic readings, high diastolic readings, or a combination of high systolic and diastolic readings.

The National Institute on Alcohol Abuse and Alcoholism reports that anyone who binges on alcohol can develop at least a short-term spike in average blood pressure levels. Longer-term heavy drinking can produce lasting increases.

Two Factors Help Explain These Realities: 

  • First, excessive alcohol intake promotes the release of natural stress hormones that reduce the amount of space inside the body’s blood vessels.
  • Second, alcohol can narrow blood vessels by activating tiny muscles contained in the vessel walls.
Workaholic having a heart attack.

Alcohol and Heart Attack

Heart attacks occur when an artery blockage disrupts the flow of oxygen-bearing blood to part of the muscle tissue that forms the organ’s main structure. Without the needed blood flow, this tissue will sustain damage or even die off completely. In severe cases, the resulting change in normal cardiac function can lead to death in a matter of minutes. Every two minutes of the day, roughly three people in the U.S. experience a mild, moderate, or severe heart attack.

Excessive drinking is known to boost the odds of experiencing this attack. That’s true because people who habitually consume large amounts of alcohol expose themselves to several major risks, including:

  • High levels of a blood-borne fat called triglyceride
  • High blood pressure
  • Obesity

In a study published in 2017 in the Journal of the American College of Cardiology, a team of American researchers used data from over 300,000 participants to gauge the impact that heavy drinking has on cardiac health. One of the measured effects was the odds of having a heart attack. The researchers found that excessive alcohol intake increases the risks, even in the absence of any other factors that make an attack more likely to occur.

Congestive Heart Failure and Alcohol Abuse

Congestive heart failure occurs when the heart can no longer send enough oxygen-rich blood through the arteries to various tissues and organs. This condition differs from both cardiac arrest and heart attack. When the circulatory system no longer functions normally, fluid begins to accumulate throughout the body.

In turn, this Buildup Leads to Symptoms that Include:

  • Breathing difficulties
  • Fatigue
  • Swelling in the lower extremities
  • Abdominal swelling
  • Swollen neck veins
  • Nighttime coughing
  • Increased urine output
  • Weight gain

Heart failure is incurable. Even with the right treatment, it can progress over months or years and produce worsening symptoms. Ultimately, the condition can result in death.

There is an established connection between congestive heart failure and alcohol. When heavy drinking acts as the source of this failure, doctors refer to the condition as alcoholic cardiomyopathy. This condition occurs in long-term heavy drinkers. It develops when chronic exposure to alcohol poisons the heart’s muscle tissue and stops the organ from performing at full capacity. Damage occurs in both the upper and lower chambers.

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Page Sources

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Published on: March 9th, 2018

Updated on: March 30th, 2021

About Author

Nena Messina, Ph.D.

Nena Messina is a specialist in drug-related domestic violence. She devoted her life to the study of the connection between crime, mental health, and substance abuse. Apart from her work as management at addiction center, Nena regularly takes part in the educational program as a lecturer.

Medically Reviewed by

Michael Espelin APRN

8 years of nursing experience in wide variety of behavioral and addition settings that include adult inpatient and outpatient mental health services with substance use disorders, and geriatric long-term care and hospice care.  He has a particular interest in psychopharmacology, nutritional psychiatry, and alternative treatment options involving particular vitamins, dietary supplements, and administering auricular acupuncture.

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