Alcoholic cardiomyopathy

Alcoholic cardiomyopathy (AKM) - is characterized by the formation of diffuse myocardial damage due to the effect of ethanol on cardiomyocytes. During the development of the disease there is a heart failure that progresses rather fast.

Today, it has been determined that almost half of people who have taken alcoholic beverages for 10 years or more develop alcoholic cardiomyopathy.In such cases, most often die from heart failure.

The disease is diagnosed using special research methods that are used in cardiology centers and clinics. Also, the question of alcoholic cardiomyopathy is occupied by a doctor-narcologist, but by its part more elimination of patients symptoms of alcohol dependence, than a violation of cardiac activity.

Video Heart of an alcoholic - heart surgeon Leo Bakeria

How does ethanol affect the heart?

Today, some companies claim that in a small amount of alcohol is not harmful, but even useful for the body. Is that true?

Numerous studies have proved the mythic nature of the assumption that alcohol is clearly beneficial to the heart.In fact, the amount of alcohol consumed is directly proportional to the severity of manifestations associated with these or other diseases of the cardiovascular system and other organs. In particular, the increase in blood pressure is often noted against the background of alcohol intake, and as soon as the patient ceases to abuse alcoholic beverages, the blood pressure decreases or is completely normalized.

The harm done to heart disease is confirmed by the following studies:

• For over 11 years, Canadian scientists have seen more than 3,000 men who were 35-79 years old. All patients had no heart and vessel disease prior to the start of the study. According to the results, it was found that there were more strokes in the control group due to the use of alcohol. If the patient was additionally determined diabetes mellitus or a chronic condition was recorded, then the dangerous effect of ethanol increased several times.
• Another study involved ambulance service. Based on the data provided by her, it was determined that in many cases alcohol was the cause of atrial fibrillation.

In this way, it turns out that ethanol affects the body and the cardiovascular system in particular. In significant doses can lead to atrial fibrillation, heart attacks, cardiomyopathy. At the same time, there is no minimum dose of alcohol in which it would be completely safe, therefore, those who wish to be healthy should not refuse alcoholic drinks altogether.

What is cardiomyopathy?

The disease is a defeat of the myocardium, characterized by thickening (hypertrophy) of the heart muscle or enlargement of the heart chamber (dilatation). As a result, stagnant phenomena in the circulatory system develop, which further exacerbates the patient's condition.

Morphological structure of alcoholic heart:

• The organ increases in size, with the walls of the ventricles hypertrophied unevenly.
• Under the epicardium, an effusion is accumulated, which is often associated with fatty fiber, which often completely covers the myocardium.
• In the thickness of the heart muscle, fatty dystrophy is commonly associated with focal sclerosis.
• The dilatation is mainly determined in the chamber of the left ventricle, with its greater severity observed in the context of chronic heart failure.

Reasons

Cardiomyopathy can develop for various reasons: due to viral diseases, genetic and autoimmune disorders, electrolyte imbalance, poisoning. Also, predisposing factors may hide in amyloidosis, cumulative disease, neuromuscular pathology, ischemic and hypertensive heart disease. In some cases, cardiomyopathy occurs due to frequent stresses, irrational nutrition, incorrect use of drugs or other chemicals.

Ethanol is a toxic substance that has a negative effect on cardiomyocytes.Under his influence, the cells of the heart stretch, because of which the heart as a whole loses elasticity and the ability to completely reduce.The second mechanism for the formation of alcoholic cardiomyopathy is a violation of the formation of proteins due to alcoholic hepatitis, which results in the heart not receiving the required nutrients.

Alcoholic cardiomyopathy develops only for one reason - due to the regular reception of alcoholic beverages (wine, beer, spirits) for a long time (10 years or more). In addition, the severity of the disease in many respects depends on the amount of alcohol taken per day. For the development of cardiomyopathy it is enough to drink alcohol each day, equivalent to 100 ml of pure ethanol.

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Species

There are several forms of alcoholic cardiomyopathy that differ in their course and manifestations:

• Classical development. The patient has been drinking alcohol for many years. Gradually developing alcoholic hepatitis, and then begin to appear pain in the area of the heart, there is a tachycardia, a feeling of interruptions in the work of the heart. Over time, shortness of breath may appear. If the patient consumed a lot of alcohol, then for the second or third day there are severe heart pain.
• Pseudo-ischemic flow. The disease develops in the form of myocardial ischemia when, after physical or emotional stress, pain in the heart is felt. Additionally, tachycardia and shortness of breath may be detected. The duration of the pain is different, its intensity often depends on the degree of progression of the disease. When examining a patient, enlarged heart size, edema may be determined.
• Arrhythmic development. In addition to the classic symptoms in the form of shortness of breath, edema is characterized by symptoms characteristic of arrhythmias. Extrasystoles, paroxysmal tachycardia may appear. On the background of these conditions, complaints of dizziness, increased sweating, pre-anxious and abnormal conditions often occur.

Clinic

Alcoholic cardiomyopathy manifests itself in characteristic symptoms and syndromes.

• Pain syndrome. Arises from "mature" alcoholics, after about a year or two of constant abuse. Pain can be severe, more often in the heart area. Together with it there is a cold extremity and cyanato color of the skin. In more complex cases, arterial pressure rises and an irregular / frequent heartbeat appears.
• Asthenic syndrome. For others, the emotional lability of the patient becomes noticeable, his imbalance and excessive irritability. Additionally, the inadequacy of behavior and fussiness in the performance of ordinary work is striking. Patient himself may notice increased fatigue and general weakness.
• Cardiac insufficiency syndrome. At first, it appears on edema only on the legs. Gradually, other parts of the body may swell, most often the hands and face, and rarely the body. Because of the broken blood supply to the tissues, the oxygen enters the disadvantage, which is expressed by acrocyanosis on the face and fingers. Additionally, a cough and a feeling of lack of air may appear.
• Arrhythmic syndrome. Interruptions in the work of the heart can be annoyed in the form of extrasystoles, but more often - in the form of paroxysmal atrial fibrillation. Breaking the rhythm often occurs during abstinence or alcohol drinking.
• Syndrome of alcohol intoxication. It manifests itself at later stages of disease development. Characterized by the appearance of signs of dementia (dementia), disturbed coordination, scattered or, conversely, aggressive behavior.

Defining two or more syndromes allows you to accurately diagnose alcoholic cardiomyopathy. The only thing that only has asthenic or intoxication symptoms does not allow the AKM to be installed. To determine the cardiac pathology, signs of cardiovascular disorders should be present.

Diagnostics

First of all, the patient is examined and conducted a collection of complaints, anamnesis of illness and life. Heredity, predisposition to drinking alcohol, way of life and diet are especially carefully clarified. In some cases, the patient's appearance helps determine the diagnosis:

• cynosity under the eyes;
• unclean clothes;
• absence of logical and adequate conclusions;
• acrocyanosis (bluish coloration of the nose, cheeks, ears, fingers).

After physical examination, the patient is assigned instrumental diagnostic methods:

• Electrocardiography - allows to detect violations of the heart rhythm, hypertrophy of the individual sections (especially the left ventricle).
• Echocardiography - allows you to determine the size of the heart chambers, the thickness of the walls of the ventricles and atrium.
• Chest X-ray is an optional study, but can be used to evaluate the state of a small circle of blood circulation.
• Ultrasound of the internal organs - Ultrasound of the liver is especially important because this organ is first and foremost amazed, and then the heart and the definition of hepatitis can confirm the presence of alcoholic cardiomyopathy.
• Laboratory tests are done for the general assessment of the patient's condition, help determine liver tests and other blood parameters indicating inflammatory and dystrophic processes. If necessary, tests are performed on the presence of ethanol in the blood.

Treatment

Complete cure for alcoholic cardiomyopathy is not possible, because the disease is associated with toxic and destructive processes that do not reverse. The only timely initiated and adequately treated treatment can slow down the progression of the pathology, which in turn will improve the patient's well-being and the quality of his life.

The main thing in the treatment of patients is the complete refusal of the patient to drink alcohol, for which coding is applied, the passage of rehabilitation in special centers, etc.

If such a condition is not respected, then it is impossible to conduct a proper treatment, as it does not bring the proper result. The focus on improving the health status allows you to prolong the life of a sick person, to make it more full-fledged and full of positive events.

In addition to fulfilling the main rule - to lead a sober way of life - you need to adhere to other equally important recommendations:

1. Dietary nutrition. The patient's menu must be varied, saturated with vitamins and protein components. If necessary, you can use pharmacological vitamin and mineral complexes, enriched with such useful vitamins as C, B1, B6, potassium and magnesium.
2. The patient's regimen should be aimed at strengthening his body, therefore, exhausting physical activity is unacceptable, although hypodynamia should not be present.
3. Medicinal treatment. It is aimed at eliminating the symptoms of the disease, strengthening the heart muscle and removing stress from it. There are various pharmacological groups, in which the most suitable combinations for the treatment of alcoholic cardiomyopathy are created.

3.1 Heart glycosides. Assigned to arrhythmias and heart failure. Helps to improve cardiac activity, remove unwanted manifestations of tachycardia.

3.2 Antiarrhythmics.Used for various rhythm disorders, especially with paroxysmal tachycardia and atrial fibrillation.

3.3 Diuretics. Used for heart failure to reduce edema.

3.4 Metabolic treatment. Allow to improve the health of the patient due to the nutrition of the myocardium and the activation of metabolic processes.

The last method of treatment - radical - is associated with heart transplant. With the successful implementation of the operation, it is possible to partially improve the patient's condition, but in most cases it is necessary to deal with the complications associated with the transplant.

Forecast and prevention

In the absence of treatment on the background of alcoholic cardiomyopathy, heart failure develops very rapidly, and further threatens the patient's death. Therefore, most often with this pathology conclude a conditionally unfavorable and unfavorable prognosis.

Only the adequate treatment of AKM and the absolutely sober life of the patient, without the slightest drinking, can only improve the prognosis.From alcoholism to independent forces it is extremely difficult to get rid of, therefore, the help of specialists is required.

Excessive alcohol consumption leads to very fast death. In just 3-4 years from the initial stage, alcoholic cardiomyopathy passes into a stage of decompensation, when sudden cardiac arrest develops on the background of heart failure at any time, especially during the course of the drinking.