Alcoholics and Heart Failure

Alcoholics and Heart Failure

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Heavy drinking damages heart muscle tissue.

George Doyle/Stockbyte/Getty Images

About 18 million people in the U.S. struggle with alcoholism, reports the National Institute on Alcohol Abuse and Alcoholism. While most people are aware of the link between alcoholism and liver disease, many are unaware that alcohol abuse can also lead to heart failure. In fact, alcoholism is a leading cause of dilated cardiomyopathy, a condition characterized by a severely enlarged and weakened heart.

Alcohol and the Heart

Although drinking alcohol in moderation -- no more than 2 drinks per day for men and 1 or fewer drinks daily for women -- has been associated with a decreased risk of coronary heart disease, excessive alcohol intake can be toxic to the heart. The authors of a March 2009 review article published in the "European Journal of Heart Failure" reported that high levels of alcohol damage the heart by causing the death of heart muscle cells. Over time, the loss of heart muscle cells and changes in the remaining heart cells can potentially lead to heart failure in alcoholics. Additionally, heavy drinking has been linked to several nutritional deficiencies involving thiamine and folate -- B vitamins that are essential for normal heart function.

Alcoholic Cardiomyopathy

Alcoholic cardiomyopathy results in profound enlargement of the heart and weakness of the heart muscle. Many people with the condition initially experience no symptoms. But as the heart grows progressively weaker, they typically develop difficulty breathing, swelling in the legs and palpitations from abnormal heart rhythms. Left untreated, alcoholic cardiomyopathy can damage other organs and lead to sudden cardiac death. A diagnosis of alcohol-related heart failure is made when other causes of dilated cardiomyopathy -- such as certain viral infections and thyroid disease -- have been ruled out in a person with a history of alcohol abuse.

Risk Factors

People who drink several alcoholic beverages on a daily basis for more than a 5-year period are at risk for alcoholic cardiomyopathy. No particular alcoholic beverage is more likely to cause alcohol-related heart failure than another. According to a May 2002 article in the journal "Chest," some people may be more sensitive to the heart-damaging effects of alcohol than others because of genetic variations. While men are more likely to be diagnosed with alcoholic cardiomyopathy, women are also at risk and may be more apt to develop the condition at lower levels of alcohol intake. Alcohol-related heart failure is typically diagnosed among people in their late 40s.


Total abstinence from alcohol can reverse the effects of alcoholic cardiomyopathy, especially if it is diagnosed before symptoms begin. Even people with symptomatic, alcohol-related heart failure can improve their chances of living long term with the condition if they stop drinking alcohol. People who have alcohol-related heart failure symptoms can benefit from medications used with other types of heart failure. Beta blockers, angiotensin-converting enzyme inhibitors and aldosterone-antagonist medications can help ease symptoms and improve survival.

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