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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