A person who abuses alcohol daily for several years is at risk for developing a potentially-reversible cardiomyopathy.


Cardiac changes over time:

(1) dilation of the left ventricle with thinning of the myocardium

(2) left ventricular hypertrophy

(3) dilated cardiomyopathy with heart failure

(4) cardiac arrhythmias including atrial fibrillation


There are 2 recognized phases:

(1) asymptomatic or preclinical, which may be associated with diastolic heart failure

(2) symptomatic, with biventricular failure with systolic and diastolic dysfunction


The patient may suddenly deteriorate if there is a surge in drinking.


The prognosis is poor if the patient continues to drink. A patient with complete abstinence often sees improvement in cardiac function within 6 months.


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