Consensus and Controversy in the Debate Over the Biphasic Impact of Alcohol Consumption on the Cardiovascular System
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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. -
The Holiday Heart Syndrome
2015/2016 Inês dos Santos Marques Alcohol and the heart março, 2016 Inês dos Santos Marques Alcohol and the heart Mestrado Integrado em Medicina Área: Cardiologia Tipologia: Monografia Trabalho efetuado sob a Orientação de: Doutor Manuel Belchior Campelo Trabalho organizado de acordo com as normas da revista: Revista Portuguesa de Cardiologia março, 2016 “Não sou mas hei de ser…” “E estou cada vez mais perto de ser…” Alcohol and the heart Álcool e coração Inês Marques1, Manuel Campelo1, 2 1Faculdade de Medicina da Universidade do Porto, Porto, Portugal 2Serviço de Cardiologia, Centro Hospitalar de São João, Porto, Portugal Corresponding author: Manuel Campelo, MD, PhD Mail: [email protected] Phone: +351 963 972 116 Number of words in the manuscript, excluding the table: 4932 1 Resumo Alguns dos efeitos benéficos da ingestão de álcool são já razoavelmente conhecidos. Contudo, os seus potenciais efeitos nefastos carecem ainda de avaliação mais detalhada. A caraterização desses efeitos em populações e contextos específicos é ainda escassa, particularmente em jovens adultos e em situações de consumo agudo e/ou em grandes quantidades. A síndroma do coração do fim-de-semana diz respeito ao desenvolvimento de uma arritmia cardíaca durante ou após o consumo agudo de uma grande quantidade de álcool, em indivíduo aparentemente saudável, e que normalmente reverte espontaneamente após um período de abstinência. Este trabalho pretende rever o estado da arte relativamente à síndroma do coração de fim-de-semana, nomeadamente nos jovens adultos. Foram selecionados na PubMed artigos referentes ao consumo de álcool no jovem e ao desenvolvimento de arritmias cardíacas. Nos adultos jovens observa-se uma acentuada heterogeneidade, no que respeita aos hábitos de consumo etílico. -
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. -
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. -
Atrial Fibrillation
Cardiology Research and Practice Atrial Fibrillation Guest Editors: Natig Gassonov, Evren Caglayan, Firat Duru, and Fikret Er Atrial Fibrillation Cardiology Research and Practice Atrial Fibrillation Guest Editors: Natig Gassonov, Evren Caglayan, Firat Duru, and Fikret Er Copyright © 2013 Hindawi Publishing Corporation. All rights reserved. This is a special issue published in “Cardiology Research and Practice.” All articles are open access articles distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Editorial Board Atul Aggarwal, USA H. A. Katus, Germany J. D. Parker, Canada Jesus´ M. Almendral, Spain Hosen Kiat, Australia Fausto J. Pinto, Portugal Peter Backx, Canada Anne A. Knowlton, USA Bertram Pitt, UK J Brugada, Spain GavinW.Lambert,Australia Robert Edmund Roberts, Canada Ramon Brugada, Canada Chim Choy Lang, UK Terrence D. Ruddy, Canada Hans R. Brunner, Switzerland F. H H Leenen, Canada Frank T. Ruschitzka, Switzerland Vicky A. Cameron, New Zealand Seppo Lehto, Finland Christian Seiler, Switzerland David J. Chambers, UK John C. Longhurst, USA Sidney G. Shaw, Switzerland Robert Chen, Taiwan Lars S. Maier, Germany Pawan K. Singal, Canada Mariantonietta Cicoira, Italy Olivia Manfrini, Italy Felix C. Tanner, Switzerland Antonio Colombo, Italy Gerald Maurer, Austria Hendrik T. Tevaearai, Switzerland Omar H. Dabbous, USA G. A. Mensah, USA G. Thiene, Italy Naranjan S. Dhalla, Canada Robert M. Mentzer, USA H. O. Ventura, USA Firat Duru, Switzerland Piera Angelica Merlini, Italy Stephan von Haehling, Germany Vladim´ır Dzavˇ ´ık, Canada Marco Metra, Italy James T. Willerson, USA Gerasimos Filippatos, Greece Veselin Mitrovic, Germany Michael S. -
EKG Zmeny Pri Akútnej Intoxikácii Alkoholom
Přehledný referát EKG zmeny pri akútnej intoxikácii alkoholom K. Trejbal, P. Mitro III. interná klinika Lekárskej fakulty UPJŠ a FN L. Pasteura Košice, Slovenská republika, prednosta doc. MUDr. Peter Mitro, Ph.D. Súhrn: U pacientov s akútnou intoxikáciou etylalkoholom sú často prítomné patologické zmeny elektrokardiogramu (EKG). Časte- jšie a prognosticky závažnejšie bývajú u chronických alkoholikov, pacientov s ischemickou chorobou srdca (ICHS), alkoholovou kardiomyopatiou, alebo iným organickým ochorením srdca, môžu sa však vyskytovať aj u mladých a zdravých jedincov. Typické EKG zmeny pri ebriete sú poruchy srdcového rytmu, a to jednak charakteru porúch tvorby vzruchu, tak aj patologického vedenia vzruchu. U ľudí bez klinického dôkazu srdcového ochorenia ich zaraďujeme pod tzv. „holiday heart syndrome“. Najčastejšia tachyarytmia je fibrilácia predsiení, zriedkavejšia, ale prognosticky podstatne závažnejšia, je polymorfná komorová tachykardia typu torsades de pointes (TdP). Z bradyarytmií je najvýznamnejšia alkoholom indukovaná sínusová bradykardia, ktorá sa môže prejaviť opakovanými synkopami. So stúpajúcou hladinou alkoholu v krvi sa zvyšuje výskyt signifikantného predĺženia jednotlivých EKG intervalov, s mož- nou manifestáciou latentnej prevodovej poruchy, či dokonca náhlej srdcovej smrti. V EKG obraze sa okrem porúch rytmu veľmi často zistia nešpecifické zmeny repolarizácie. U pacientov s ICHS dochádza pri alkoholovej intoxikácii k prehĺbeniu ischémie, ktorá prebie- ha väčšinou asymptomaticky ako tichá ischémia myokardu. Výsledný EKG obraz môžu výrazne ovplyvniť stavy, ktoré sa neraz vysky- tujú súčasne s opitosťou, ako napr. hypotermia, hypoglykémia či elektrolytová dysbalancia. Podobné EKG zmeny ako pri akútnej alkoholovej intoxikácii, vznikajú aj pri akútnom abstinenčnom syndróme, najmä pri delíriu tremens. Existujú presvedčivé dôkazy o tom, že nielen chronický alkoholizmus, ale aj nárazové pitie je spojené so zvýšením kardiovaskulárnej mortality. -
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. -
Variance in Clinical Profile and Use of Anticoagulants in Valvular and Non Valvular Atrial Fibrillation
World Journal of Cardiovascular Diseases, 2020, 10, 488-499 https://www.scirp.org/journal/wjcd ISSN Online: 2164-5337 ISSN Print: 2164-5329 Variance in Clinical Profile and Use of Anticoagulants in Valvular and Non Valvular Atrial Fibrillation Smriti Shakya*, Arun Sayami, Ratna Mani Gajurel, Chandra Mani Poudel, Hemant Shrestha, Surya Devkota, Sanjeev Thapa, Rajaram Khanal Department of Cardiology, Manmohan Cardiothoracic Vascular and Transplant Centre (MCVTC), Institute of Medicine, TUTH, Kathmandu, Nepal How to cite this paper: Shakya, S., Sayami, Abstract A., Gajurel, R.M., Poudel, C.M., Shrestha, H., Devkota, S., Thapa, S. and Khanal, R. (2020) Introduction: Atrial fibrillation is the most common cardiac arrhythmia en- Variance in Clinical Profile and Use of An- countered in clinical practice that affects morbidity and mortality to a large ticoagulants in Valvular and Non Valvular extent. This study was intended to determine various clinical profile and eti- Atrial Fibrillation. World Journal of Cardi- ological factors in valvular and non-valvular atrial fibrillation and evaluate ovascular Diseases, 10, 488-499. https://doi.org/10.4236/wjcd.2020.107049 the usage of anticoagulants in them in the settings of developing nation like ours. Methods: A hospital based cross-sectional observational prospective Received: June 29, 2020 study was conducted at Manmohan Cardiothoracic Vascular and Transplant Accepted: July 24, 2020 Center, Institute of Medicine, Nepal for a period of sixteen months. All the Published: July 27, 2020 patients with atrial fibrillation who were admitted in the cardiology depart- Copyright © 2020 by author(s) and ment were included. The demographic profile, etiology, clinical features and Scientific Research Publishing Inc. -
Holiday Heart Syndrome Revisited After 34 Years
FACULDADE DE MEDICINA DA UNIVERSIDADE DE COIMBRA TRABALHO FINAL DO 6º ANO MÉDICO COM VISTA À ATRIBUIÇÃO DO GRAU DE MESTRE NO ÂMBITO DO CICLO DE ESTUDOS DE MESTRADO INTEGRADO EM MEDICINA DAVID MANUEL MARQUES PINTO TONELO HOLIDAY HEART SYNDROME REVISITED AFTER 34 YEARS ARTIGO DE REVISÃO ÁREA CIENTÍFICA DE CARDIOLOGIA TRABALHO REALIZADO SOB A ORIENTAÇÃO DE: RUI ANDRÉ QUADROS BEBIANO DA PROVIDÊNCIA E COSTA SETEMBRO 2012 Holiday Heart Syndrome revisited after 34 years David Tonelo BSc*, Rui Providência MD MSc, Lino Gonçalves MD PhD FESC Faculty of Medicine, University of Coimbra, Portugal Abstract Cardiovascular effects of ethanol have been known for a long time. However most research has focused on beneficial effects (the “French--Paradox”) when consumed moderately or its harmful consequences, such as dilated cardiomyopathy, when heavily consumed for a long time. An association between acute alcohol ingestion and onset of cardiac arrhythmias was first reported in early 70’s. In 1978 Phill Ettinger described for the first time “Holiday Heart Syndrome” as the occurrence, in healthy people without heart disease known to cause arrhythmia, of an acute cardiac rhythm disturbance, most frequently atrial fibrillation, after binge drinking. This name derived from the fact episodes were initially observed more frequently after weekends or public holidays. Thirty-four years have passed since original description of “Holiday Heart Syndrome”, with new research in this field, increasing the knowledge about this entity. Throughout this paper the authors will comprehensively review most of the available data concerning the “Holiday Heart Syndrome” and highlight the currently unsolved questions. Keywords: Holiday Heart Syndrome; Alcohol; Cardiac arrhythmia *Corresponding author: Tel: +351 918820405; E-mail address: [email protected] (D.Tonelo) 22 Introduction Alcohol is one of the oldest known drugs and it’s the most used recreational drug in the United States of America1 and probably in the rest of the globe. -
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. -
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. -
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.