Cobalt Cardiomyopathy (Beer Drinker's Cardiomyopathy)

Was the patient previously healthy?

Has the patient been exposed to a cobalt salt in food or beverage?

Has the person accidentally ingested a cobalt salt?

Does the patient grind or cut metals including cobalt alloys?

Is the serum cobalt or urine concentration elevated?

Are cobalt levels increased in hair and/or nails?

Is there another cause for heart disease that can explain the findings better?