DOCSLIB.ORG

Reversibility of Alcoholic Cardiomyopathy MARKKU KUPARI M.D

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
Reversibility of Alcoholic Cardiomyopathy MARKKU KUPARI M.D Postgrad Med J: first published as 10.1136/pgmj.60.700.151 on 1 February 1984. Downloaded from Postgraduate Medical Journal (February 1984) 60, 151-154 Reversibility of alcoholic cardiomyopathy MARKKU KUPARI M.D. First Department ofMedicine, University of Helsinki; and Research Laboratories ofthe State Alcohol Monopoly (Alko), Helsinki, Finland Summary Case report A patient with alcoholic cardiomyopathy is described A 32-year-old seaman was admitted to hospital in in whom cardiovascular function capacity and radio- December 1978 because of advancing heart failure. logical heart size fluctuated widely with periods of He had been well until 6 weeks earlier when heavy drinking and abstinence. On two occasions, shortness of breath and fatigue on exertion first cessation of drinking resulted in clinical recovery appeared after a 3-week period of exceptionally from severe degrees of congestive failure and in heavy alcohol abuse. He admitted to excessive complete reversal of cardiac enlargement. Echocardi- drinking since 1970 and his approximate alcohol ographic follow-up showed, however, that the true consumption had amounted to 150-200 grams/day by copyright. rapidity of myocardial recovery was much slower than during the last 2 years before admission. He gave no estimated clinically and radiologicaHly and than sug- history of hypertension, chest pain or recent viral gested by the previous reports. illness and was a non-smoker. On examination, the patient appeared well nour- ished and without signs of chronic liver disease. KEY WORDS: cardiac failure, echocardiography. Heart rate was 102 beats/min and blood pressure was 110/80 mmHg. There was a third heart sound, Introduction marked jugular venous distension and the liver was palpable 3 cm below the right costal margin. The The natural course of congestive alcoholic cardio- showed sinus P-wave electrocardiogram tachycardia, http://pmj.bmj.com/ myopathy is poor: over 40% of such patients died changes indicative of left atrial strain and ST within an average time of 3 years in a prospective segment depression as well as T-wave inversion study (Demakis et al., 1974). By abstention from suggestive of left ventricular strain. The chest roent- alcohol, the patients seemed to benefit so that 61% of genogram disclosed cardiac enlargement; the cardio- abstaining patients were clinically improved in con- thoracic ratio was 0 55 (Fig. la). Apart from macro- trast with only 10% of those who continued heavy cytosis of the red cells, the routine blood tests were drinking. Moreover, three previous case reports non-revealing. Tests for antinuclear antibodies were (Schwartz, Sample and Wigle, 1975; Baudet et al., negative as were the serologic reactions for syphilis on September 28, 2021 by guest. Protected 1979; Hung et aL, 1979) have objectively shown that and streptococcal, viral, and rickettsial diseases. A even severe degrees of congestive failure due to tentative diagnosis of alcoholic cardiomyopathy was alcoholic heart muscle disease are potentially totally made and the patient was discharged on digoxin and reversible. The recovery from overt failure to normal hydrochlorthiazide and advised to refrain from cardiac function in these patients took from 8-18 drinking. months. The condition of the patient improved rapidly The patient reported in this paper serves to during abstinence and he resumed his professional emphasize the necessity of total and permanent activities 4 months after the discharge from hospital. cessation of drinking for successful treatment of All medications were discontinued in June 1979. In alcoholic heart disease. This case also demonstrates December 1979, 1 year after admission, the patient the usefulness of serial echocardiographic studies was symptom-free and the clinical cardiac examina- in following the restoration of myocardial perform- tion was interpreted normal. The chest X-rays ance. showed a return of heart size to normal; the Postgrad Med J: first published as 10.1136/pgmj.60.700.151 on 1 February 1984. Downloaded from 152 Clinical reports JRSil!:n>s~~~~~~~~~~~~~~~~~~~~~~..' by copyright. L:,.aVl.tE:,!~~~~ '...... ... .' ti http://pmj.bmj.com/ on September 28, 2021 by guest. Protected FIG. 1. X-ray studies of the chest: on admission in December 1978 (A), after 1 year of abstinence in December 1979 (B), on readmission in March 1981 (C), and after a 6-month abstinence in September 1981 (D). cardiothoracic ratio was 0-38 (Fig. lb). Though much breathlessness 4 days before admission. On examina- diminished, T-wave inversion still persisted in the tion, there was a summation gallop as well as a leads V4-V6 of the electrocardiogram. The patient murmur of mitral insufficiency. The electrocardiog- was considered almost fully recovered and was ram showed left atrial and left ventricular strain and discharged from follow-up. occasional ventricular premature beats in addition to In March 1981, the patient was readmitted because sinus tachycardia. The chest roentgenogram revealed of congestive heart failure (Fig. lc). He had been well a recurrence of cardiac enlargement as well as and maintained abstinence until 2 weeks earlier when pulmonary venous engorgement and interstitial ex- he relapsed into alcohol abuse imbibing approxi- travasation. The routine blood tests were normal and mately 3/4 litres of whisky daily till the onset of the antiviral antibodies showed no acute reactions; Postgrad Med J: first published as 10.1136/pgmj.60.700.151 on 1 February 1984. Downloaded from Clinical reports 153 TABLE 1. Non-invasive follow-up of left ventricular performance during abstinence after the second admission Months of abstinence Variable Reference range* 0 6 12 18 Heart rate (beats/min) 94 81 72 66 Blood pressure (mmHg) 100/70 114/70 116/70 116/70 LVEDD (mm) 74 62 67 63 41-57 LVESD (mm) 67 55 58 52 26-41 PWT (mm) 11 13 11 11 7-12 LVM (g) 242 239 216 200 90-192 Fractional shortening (%) 10 12 14 18 24-42 PEP/LVET 0-54 0 57 0-48 0 40 0 26-040 LVEDD and LVESD=left ventricular end-diastolic and end-systolic diameters, respectively, measured by the European standardization (Roelandt and Gibson, 1980); PWT=posterior wall end- diastolic thickness; LVM = left ventricular mass (Troy, Pombo and Rackley, 1972); PEP/LVET-pre- ejection period/left ventricular ejection time ratio, derived from simultaneous recordings of electrocardiogram, phonocardiogram, and carotid arterial pulse tracing (Lewis et al., 1977). *The reference ranges are the 95% confidence intervals in twenty healthy male subjects aged 23-62 ~~~~~~Iyears (mean age, 36 years). a:~~~ by copyright. w~~~~~* - . ¼ic http://pmj.bmj.com/ on September 28, 2021 by guest. Protected FIG. 2. M-mode echocardiographic studies of the left ventricle on readmission in March 1981 (A) and after a 6-month abstention from alcohol (B). Note the diminution of left ventricular transverse diameters; the depth scales are nearly identical. haemochromatosis was also excluded. A left ventri- tained total abstinence and again rapidly improved. cular echocardiographic study and measurement of All medications were discontinued in June 1981 and the systolic time intervals gave findings typical of the patient resumed his working activities. In Sep- congestive cardiomyopathy (Fig. 2a, Table 1). The tember 1981, 6 months after the readmission, he was patient was started on digoxin and prazosin and a symptom-free apart from slight dyspnoea on effort; small dose of metoprolol was later added to the neither murmurs nor gallop sounds were heard on regimen. auscultation. The chest X-rays revealed again a After discharge from hospital, the patient main- normal-sized heart (Fig. Id). Nevertheless, left ven- Postgrad Med J: first published as 10.1136/pgmj.60.700.151 on 1 February 1984. Downloaded from 154 Clinical reports tricular dilatation and hypokinesia, although dimin- which were acutely exacerbated by the toxic insult ished, still persisted on the echocardiographic study from heavy alcohol intake. Abstention from drinking (Fig. 2b, Table 1) and the electrocardiogram showed must be total and permanent to be curative in negative T-waves in the leads V4-V6. Until Septem- alcoholic heart disease. ber 1982, the patient has maintained abstinence, and repeated echocardiographic studies 12 and 18 months References after the 2nd admission have shown a steady but slow in left ventricular performance (Table BAUDET, M., RIGAUD, M., ROCHA, P., BARDET, J. & BOURDARIAS, improvement J.P (1979) Reversibility of alcoholic cardiomyopathy with absten- 1). tion from alcohol. Cardiology, 64, 317. DEMAKIS, J.G., PROSKEY, A., RAHIMTOOLA, S.H., JAMIL, M., SUT- Discussion TON, G.C., ROSEN, K.M., GUNNAR, R.M. & TOBIN, J.R. (1974) The natural course of alcoholic cardiomyopathy. Annals of The case presented herein supports the few earlier Internal Medicine, 80, 293. reports on the reversibility of alcoholic cardiomyo- HUNG, J., HARRIS, P.J., KELLY, D.T., RICHMOND, D.R., HUTTON, B.F. & BAUTOVICH, G. (1979) Improvement of left ventricular pathy. On the other hand, this case shows also that, function in alcoholic cardiomyopathy documented by serial gated although the initial clinical improvement can be cardiac pool scanning. Australian and New Zealand Journal of rapid, the restoration of cardiac performance during Medicine, 9, 420. abstinence either may remain incomplete or can take LEWIS, R.P., RITTGERS, S.E., FORESTER, W.F. & BOUDOULAS, H.A. (1977) A critical review of the systolic time intervals. Circulation, a much longer time than suggested by the previous 56, 146. case histories (Schwartz et al., 1975; Baudet et al., ROELANDT, J. & GIBSON, D.G. (1980) Recommendations for 1979; Hung et al., 1979). On clinical grounds alone, standardization of measurements of M-mode echocardiograms. without the use of echocardiography, the rapidity of European Heart Journal, 1, 375. SCHWARTZ, L., SAMPLE, K.A. & WIGLE, E.D. (1975) Severe alco- myocardial recovery would have been greatly over- holic cardiomyopathy reversed with abstention from alcohol. estimated in the present case. The slowness of this American Journal of Cardiology, 36, 963.
Load more

Recommended publications
  • Alcoholic Cardiomyopathy in a 39 Year Old Female: a Case Report U D.I., a JI, J DE
    The Internet Journal of Cardiology ISPUB.COM Volume 10 Number 1 Alcoholic Cardiomyopathy In A 39 Year Old Female: A Case Report U D.I., A JI, J DE Citation U D.I., A JI, J DE. Alcoholic Cardiomyopathy In A 39 Year Old Female: A Case Report. The Internet Journal of Cardiology. 2010 Volume 10 Number 1. Abstract Background: Alcoholic cardiomyopathy is a dilated cardiomyopathy, caused by long standing chronic ingestion of alcohol. It is very similar to idiopathic dilated cardiomyopathy (DCM). However, total cessation of alcohol is strongly associated with improvement of symptoms and even reversal of the DCM. Method: Case Report Result: A 39 year old school teacher, presented on account of progressive dyspnoea associated with orthopnea, palpitations and bilateral leg swelling. There was no previous remarkable illness or hospital admission. She had a history of daily ingestion of alcohol based fertility potions for 8 years.On examination she was in respiratory distress, had bilateral basal crepitations, an irregular pulse, elevated jugular venous pulse, a displaced non heaving apex with left parasternal heave, and a non radiating apical pansystolic murmur. She also had a tender hepatomegaly, and bilateral pitting pedal oedema.A chest radiograph showed upperlobe diversion, bilateral hilar opacities and a multichamber cardiomegaly. A 12 lead surface electrocardiogram (ECG) showed atrial supraventricular and ventricular ectopics, and echocardiography showed, four chamber dilatation with poor systolic function and absent a waves. Conclusion: Congestive cardiac failure (CCF) secondary to alcoholic cardiomyopathy, precipitated by arrhythmias. INTRODUCTION was no facial or abdominal swelling. She admitted to some Alcoholic cardiomyopathy is a common cause of dilated reduction in urine volume.
    [Show full text]
  • THE STUDY of HEART MUSCLE in CHRONIC ALCOHOLICS Girish M1, K
    Jebmh.com Original Article THE STUDY OF HEART MUSCLE IN CHRONIC ALCOHOLICS Girish M1, K. Mohan Pai2, Francis N. P. Monteiro3, Arun Pinchu Xavier4 1Associate Professor, Department of General Medicine, Kasturba Medical College, Mangalore, Manipal University. 2Professor, Department of General Medicine, A. J. Institute of Medical Sciences and Research Centre, Mangalore. 3Professor, Department of Forensic Medicine and Toxicology, A. J. Institute of Medical Sciences and Research Centre, Mangalore. 4Postgraduate cum Tutor, Department of Forensic Medicine and Toxicology, A. J. Institute of Medical Sciences and Research Centre, Mangalore. ABSTRACT BACKGROUND Alcohol affects many organs, especially the liver, pancreas and brain. Although, the beneficial effects of mild or moderate ethanol consumption have been implied with respect to coronary artery disease, excessive ethanol consumption can result in Alcoholic Heart Muscle Disease (AHMD). AIMS Alcohol consumption, mainly arrack, is common social problem in Mangalore. This study has been undertaken to assess the effects of alcohol on cardiovascular system. MATERIALS AND METHODS Thirty patient with history of consumption of about 6 units of alcohol per day for at least 5 days a week for at least 5 years who were admitted to Government Wenlock Hospital, Attavar K.M.C. and University Medical Centre, Mangalore, were selected as case and studied. RESULTS Alcohol intake is predominantly observed in males, majority of alcoholic had high blood pressure, serum levels of CPK-MB and LDH are elevated in chronic alcoholic patients, left ventricular hypertrophy, premature ventricular contraction and sinus tachycardia were common findings in the electrocardiograms of chronic alcoholic patients and development of alcoholic heart muscle disease is directly proportional to the quantity and duration of alcohol intake.
    [Show full text]
  • Multiscale Classification of Heart Failure Phenotypes by Unsupervised
    www.nature.com/scientificreports OPEN Multiscale classifcation of heart failure phenotypes by unsupervised clustering of unstructured electronic medical record data Tasha Nagamine1, Brian Gillette2,3, Alexey Pakhomov1, John Kahoun1,4, Hannah Mayer5, Rolf Burghaus5, Jörg Lippert5 & Mayur Saxena1* As a leading cause of death and morbidity, heart failure (HF) is responsible for a large portion of healthcare and disability costs worldwide. Current approaches to defne specifc HF subpopulations may fail to account for the diversity of etiologies, comorbidities, and factors driving disease progression, and therefore have limited value for clinical decision making and development of novel therapies. Here we present a novel and data-driven approach to understand and characterize the real-world manifestation of HF by clustering disease and symptom-related clinical concepts (complaints) captured from unstructured electronic health record clinical notes. We used natural language processing to construct vectorized representations of patient complaints followed by clustering to group HF patients by similarity of complaint vectors. We then identifed complaints that were signifcantly enriched within each cluster using statistical testing. Breaking the HF population into groups of similar patients revealed a clinically interpretable hierarchy of subgroups characterized by similar HF manifestation. Importantly, our methodology revealed well-known etiologies, risk factors, and comorbid conditions of HF (including ischemic heart disease, aortic valve disease, atrial fbrillation, congenital heart disease, various cardiomyopathies, obesity, hypertension, diabetes, and chronic kidney disease) and yielded additional insights into the details of each HF subgroup’s clinical manifestation of HF. Our approach is entirely hypothesis free and can therefore be readily applied for discovery of novel insights in alternative diseases or patient populations.
    [Show full text]
  • Moderate Excess Alcohol Consumption and Adverse Cardiac Remodelling
    Heart failure and cardiomyopathies Original research Heart: first published as 10.1136/heartjnl-2021-319418 on 11 August 2021. Downloaded from Moderate excess alcohol consumption and adverse cardiac remodelling in dilated cardiomyopathy Upasana Tayal ,1,2 John Gregson,3 Rachel Buchan,1,2 Nicola Whiffin,1,2 Brian P Halliday,1,2 Amrit Lota,1,2 Angharad M Roberts,4 A John Baksi,1,2 Inga Voges,2 Julian W E Jarman,1,2 Resham Baruah,2 Michael Frenneaux,2 John G F Cleland,1,5 Paul Barton,1,2 Dudley J Pennell,1,2 James S Ware,1,2,4 Stuart A Cook,4,6 Sanjay K Prasad1,2 ► Additional supplemental ABSTRACT consumption may be associated with a lower risk for material is published online Objective The effect of moderate excess alcohol heart failure.2 However, Mendelian methodolog- only. To view, please visit the ical approaches have raised doubts regarding the journal online (http:// dx. doi. consumption is widely debated and has not been well org/ 10. 1136/ heartjnl- 2021- defined in dilated cardiomyopathy (DCM). There is need cardioprotective effects of low to moderate alcohol 319418). for a greater evidence base to help advise patients. We consumption.3 Guidance on alcohol consumption is frequently requested by patients with no clear 1 sought to evaluate the effect of moderate excess alcohol National Heart and Lung consumption on cardiovascular structure, function and evidence base to advise patients. Institute, Imperial College London, London, UK outcomes in DCM. It is established that chronic excess alcohol 2Royal Brompton Hospital, Methods Prospective longitudinal observational cohort consumption can lead to an alcoholic cardiomy- London, UK study.
    [Show full text]
  • The Electrocardiogram of Alcoholic Cardiomyopathy
    Br Heart J: first published as 10.1136/hrt.21.4.445 on 1 October 1959. Downloaded from THE ELECTROCARDIOGRAM OF ALCOHOLIC CARDIOMYOPATHY BY WILLIAM EVANS From the Cardiac Department of the London Hospital Received December 1, 1958 The harmful effects of excessive alcohol consumption on the liver have long been recognized. A corresponding injury to the heart has not received the same attention except as part of the syndrome of beriberi attributable to thiamine deficiency. Not infrequently, however, when some form of heart disease is suspected on account of symptoms like breathlessness, palpitation, or chest pain, and when signs elicited from examination of the heart are equivocal, the true diagnosis may go undiscovered, especially if coronary arterial disease is too readily imputed as the cause of electro- cardiographic changes that may be present. In such instances, information about the quantity of alcohol consumed is seldom sought, and addiction to it is not rigorously canvassed. It should be known that when the ill-effects of alcohol on the myocardium are slight, withdrawal of alcohol can halt the pathological process, but should these earlier injurious effects go unheeded through some years, the resulting cardiomyopathy will no longer subside following such abstinence. It is for this reason that early myocardial damage from alcoholism is so important to detect, and it is the purpose of this paper to describe changes in the electrocardiogram that will facilitate this readier recognition. http://heart.bmj.com/ HOW THE PATIENTS WERE ASSEMBLED The first patient in this series attended at the request of his family doctor on account of breath- lessness and with a history of alcoholism over many years.
    [Show full text]
  • 74B1b75e87a398e05738d3a0a
    Alterations of Heart Rate Variability and Heart Rate Turbulence in Patients with Dilated Alcoholic and Non-alcoholic Cardiomyopathy GHEORGHE NICUSOR POP, COSMIN FAUR*, ADRIAN GOLDIS*, ANDREI BECEANU, AHMED ABU-AWWAD, TUDOR CIOCARLIE Victor Babes University of Medicine and Pharmacy, 2 Eftimie Murgu Sq., 300041, Timisoara, Romania The aim of this study is to document the imbalance of the autonomic nervous system (ANS), expressed by heart rate variability (HRV) and heart rate turbulence (HRT), in patients with alcoholic cardiomyopathy (ACM) in comparison to those with idiopathic cardiomyopathy (ICM) and to evidence the existing differences regarding the long term evolution of these two subgroups. We studied HRV, in time and frequency domain, and HRT in 58 patients newly diagnosed with dilated cardiomyopathy (DCM), admitted between Mar 2015 and Dec 2017 for arrhythmias and/or acute congestive heart failure (CHF) in the Cardiology Clinic of our hospital. Depending on the aetiology of DCM, patients with no other obvious aetiology were assigned to two groups: A - ACM, with history of heavy alcohol consumption and B - with ICM. We performed 24 hours Holter monitoring in patients and controls. Regarding HRV parameters in time domain, they were significantly depressed in patients with ACM, comparing to those with ICM. Referring to HRT, all patients had abnormal, positive values of turbulence onset (TO) and we documented statistically significant differences (p<0.001) between the two groups. All patients had normal positive values of turbulence slope (TS). We documented, both in patients with ACM and ICM, depressed values of HRV parameters in time domain, as well as pathological values of TO.
    [Show full text]
  • Consensus and Controversy in the Debate Over the Biphasic Impact of Alcohol Consumption on the Cardiovascular System
    nutrients Review Consensus and Controversy in the Debate over the Biphasic Impact of Alcohol Consumption on the Cardiovascular System 1,2 2, 3 1,2 Cristian Stătescu , Alexandra Clement *, Ionela-Lăcrămioara S, erban and Radu Sascău 1 Internal Medicine Department, “Grigore T. Popa” University of Medicine and Pharmacy, 700503 Ias, i, Romania; [email protected] (C.S.); [email protected] (R.S.) 2 Cardiology Department, Cardiovascular Diseases Institute “Prof. Dr. George I.M. Georgescu”, 700503 Ias, i, Romania 3 Physiology Department, “Grigore T. Popa” University of Medicine and Pharmacy, 700503 Ias, i, Romania; ionela.serban@umfiasi.ro * Correspondence: [email protected]; Tel.: +40-0232-211-834 Abstract: In the past few decades, research has focused on the importance of addressing modifiable risk factors as a means of lowering the risk of cardiovascular disease (CVD), which represents the worldwide leading cause of death. For quite a long time, it has been considered that ethanol intake has a biphasic impact on the cardiovascular system, mainly depending on the drinking pattern, amount of consumption, and type of alcoholic beverage. Multiple case-control studies and meta- analyses reported the existence of a “U-type” or “J-shaped” relationship between alcohol and CVD, as well as mortality, indicating that low to moderate alcohol consumption decreases the number of adverse cardiovascular events and deaths compared to abstinence, while excessive alcohol use has unquestionably deleterious effects on the circulatory system. However, beginning in the early 2000s, the cardioprotective effects of low doses of alcohol were abnegated by the results of large epidemiological studies. Therefore, this narrative review aims to reiterate the association of alcohol Citation: St˘atescu,C.; Clement, A.; use with cardiac arrhythmias, dilated cardiomyopathy, arterial hypertension, atherosclerotic vascular S, erban, I.-L.; Sasc˘au,R.
    [Show full text]
  • Effects of Alcoholism on Coronary Artery Disease and Left Ventricular Dysfunction in Male Veterans
    Original Contribution Effects of Alcoholism on Coronary Artery Disease and Left Ventricular Dysfunction in Male Veterans Spyros Kokolis, MD, Jonathan D. Marmur, MD, Luther T. Clark, MD, John Kassotis, MD, Rodamanthos Kokolis, MD, Erdal Cavusoglu, MD, Reuven Lapin, PA-C, *Sheldon Breitbart, MD, Jason M. Lazar, MD ABSTRACT: Background. Heavy alcohol consumption is a well- and nonhemorrhagic stroke.3 The coronary protective effects of known cause of dilated cardiomyopathy and hypertension, but its effects heavy alcohol consumption have not been well studied. Chronic on coronary atherosclerosis are less well understood. The objective of this heavy alcohol consumption is a well-known cause of dilated car- study was to compare coronary anatomy and left ventricular dysfunction diomyopathy. The deleterious effects of heavy alcohol on left ven- in patients with and without alcoholism associated with heavy consump- tricular function and on arrythmogenesis may counterbalance any tion. Methods. We studied 100 consecutive alcoholic male patients pre- 4 senting with chest pain to the Department of Veterans Affairs New York potential coronary benefits. Few studies have addressed both Harbor Healthcare System (VA) between 1994 and 2002. Alcoholism CAD and left ventricular function in patients chronically con- was defined as a history of either chronic alcohol-related pancreatitis or suming large quantities of alcohol. Accordingly, the objective of liver cirrhosis. Patients were compared to age-matched controls (n = 200) this study was to assess the associations between alcoholism, that were known to be nonalcoholic. All patients underwent coronary CAD severity and left ventricular systolic dysfunction. angiography. Results. Baseline demographic characteristics were simi- lar between the two groups.
    [Show full text]
  • Alcoholic Cardiomyopathy
    Clinical and Medical Investigations Review Article ISSN: 2398-5763 Alcoholic cardiomyopathy: A review of literature on clinical status and meta-analysis of diagnostic and clinical management methods Aref Albakri* St-Marien hospital Bonn Venusberg, Department of internal medicine, Bonn, Germany Abstract The Center for Disease Control and Prevention (CDC), based on the Alcohol-Related Disease Impact (ARDI) tool, approximates 79,000 deaths annually due to excessive alcohol use. The rates of excessive alcohol use in young adults including college students at the most productive phase of life accounts for a third of lifestyle related cause of death after tobacco use and improper diet/sedentary lifestyle. A significant part of alcohol related deaths are attributable to cardiac death, a condition clinically referred to as alcoholic cardiomyopathy (ACM). The present study seeks to combine current research findings to advance knowledge of alcoholic cardiomyopathy with a view of improving diagnosis and clinical management. The review focusses on clinical description, manifestations, risk factors, pathophysiology, etiology diagnosis and clinical management of ACM. Introduction Currently, both the European Society of Cardiology (ESC) and the American Heart Association (AHA) consider ACM as a distinct Cardiomyopathy is a severe disorder of the heart muscle clinical entity [10]. The ESC classifies ACM as an acquired form of characterized by significant functional and/or electrical dysfunction dilated cardiomyopathy (DCM). The diagnosis of ACM is often one of of the myocardium. The most devastating complication is progressive exclusion of DCM patients with a long history of chronic and excessive heart failure with considerable morbidity and mortality [1]. consumption of alcohol [3].
    [Show full text]
  • Chemical Cardiomyopathies: the Negative Effects of Medications and Nonprescribed Drugs on the Heart
    Thomas Jefferson University Jefferson Digital Commons Division of Cardiology Faculty Papers Division of Cardiology 6-1-2011 Chemical cardiomyopathies: the negative effects of medications and nonprescribed drugs on the heart. Vincent M Figueredo Thomas Jefferson University Follow this and additional works at: https://jdc.jefferson.edu/cardiologyfp Part of the Cardiology Commons Let us know how access to this document benefits ouy Recommended Citation Figueredo, Vincent M, "Chemical cardiomyopathies: the negative effects of medications and nonprescribed drugs on the heart." (2011). Division of Cardiology Faculty Papers. Paper 10. https://jdc.jefferson.edu/cardiologyfp/10 This Article is brought to you for free and open access by the Jefferson Digital Commons. The Jefferson Digital Commons is a service of Thomas Jefferson University's Center for Teaching and Learning (CTL). The Commons is a showcase for Jefferson books and journals, peer-reviewed scholarly publications, unique historical collections from the University archives, and teaching tools. The Jefferson Digital Commons allows researchers and interested readers anywhere in the world to learn about and keep up to date with Jefferson scholarship. This article has been accepted for inclusion in Division of Cardiology Faculty Papers by an authorized administrator of the Jefferson Digital Commons. For more information, please contact: [email protected]. AS SUBMITTED TO: AMERICAN JOURNAL OF MEDICINE AND LATER PUBLISHED AS: CHEMICAL CARDIOMYOPATHIES: THE NEGATIVE EFFECTS
    [Show full text]
  • Alcohol Use Disorders and the Heart Day, Ed; Rudd, James
    CORE Metadata, citation and similar papers at core.ac.uk Provided by University of Birmingham Research Portal Alcohol use disorders and the heart Day, Ed; Rudd, James DOI: 10.1111/add.14703 License: Creative Commons: Attribution (CC BY) Document Version Publisher's PDF, also known as Version of record Citation for published version (Harvard): Day, E & Rudd, J 2019, 'Alcohol use disorders and the heart', Addiction. https://doi.org/10.1111/add.14703 Link to publication on Research at Birmingham portal Publisher Rights Statement: Checked for eligibility: 23/07/2019 Day, E., and Rudd, J. H. F. ( 2019) Alcohol use disorders and the heart. Addiction. https://doi.org/10.1111/add.14703. General rights Unless a licence is specified above, all rights (including copyright and moral rights) in this document are retained by the authors and/or the copyright holders. The express permission of the copyright holder must be obtained for any use of this material other than for purposes permitted by law. •Users may freely distribute the URL that is used to identify this publication. •Users may download and/or print one copy of the publication from the University of Birmingham research portal for the purpose of private study or non-commercial research. •User may use extracts from the document in line with the concept of ‘fair dealing’ under the Copyright, Designs and Patents Act 1988 (?) •Users may not further distribute the material nor use it for the purposes of commercial gain. Where a licence is displayed above, please note the terms and conditions of the licence govern your use of this document.
    [Show full text]
  • Alcoholic Cardiomyopathy: a Review
    Thomas Jefferson University Jefferson Digital Commons Division of Cardiology Faculty Papers Division of Cardiology 10-1-2011 Alcoholic cardiomyopathy: a review. Anil George Einstein Institute for Heart and Vascular Health, Albert Einstein Medical Center Vincent M Figueredo Jefferson Medical College Follow this and additional works at: https://jdc.jefferson.edu/cardiologyfp Part of the Cardiology Commons Let us know how access to this document benefits ouy Recommended Citation George, Anil and Figueredo, Vincent M, "Alcoholic cardiomyopathy: a review." (2011). Division of Cardiology Faculty Papers. Paper 11. https://jdc.jefferson.edu/cardiologyfp/11 This Article is brought to you for free and open access by the Jefferson Digital Commons. The Jefferson Digital Commons is a service of Thomas Jefferson University's Center for Teaching and Learning (CTL). The Commons is a showcase for Jefferson books and journals, peer-reviewed scholarly publications, unique historical collections from the University archives, and teaching tools. The Jefferson Digital Commons allows researchers and interested readers anywhere in the world to learn about and keep up to date with Jefferson scholarship. This article has been accepted for inclusion in Division of Cardiology Faculty Papers by an authorized administrator of the Jefferson Digital Commons. For more information, please contact: [email protected]. As submitted to: Journal of Cardiac Failure And later published as: Alcoholic Cardiomyopathy: A review. Volume 17, Issue 10, October 2011, Pages 844-849 DOI: 10.1016/j.cardfail.2011.05.008 Anil George, MD 1, Vincent M. Figueredo, MD 1,2 1 Einstein Institute for Heart and Vascular Health, Albert Einstein Medical Center and 2Jefferson Medical College, Philadelphia Key words: cardiomyopathy, alcohol, heart failure, systolic dysfunction, diastolic dysfunction Address correspondence to: Vincent M.
    [Show full text]