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5 Nisan 2021 Pazartesi

ALCOHOLIC CARDIOMYOPATHY

Although the incidence in alcoholic women and men is similar, it is almost 9 times higher in overall weight in men. It is most common in 45-59 years old.

Women develop alcoholic CMP at a lower total ethanol dose.

Left vetricular dysfunction correlates with lifetime alcohol intake.

The relationship of alcohol with heart failure follows the “J-curve. In other words, a person who takes 7 glasses of ethanol per week (14 grams of ethanol per day) actually seems to experience some reduction in heart failure risk.

Many people who have developed alcoholic CMP are those who have consumed more than 80-90 grams of alcohol per day for more than 5 years. There are studies that say 15 years on average.

Alcohol intoxication can also cause acute asymptomatic heart failure in healthy individuals.

It is in rough correlation with liver cirrhosis.

Pathogenesis is not fully understood. Acetaldehyde is thought to cause myocardial depression. There is no clarity on many other possible mechanisms.

Pathological findings and clinical findings resemble heart failure due to other etiologies.

Alcoholic CMP is diagnosed by the presence of two of the following three criteria:

  • Long-term heavy alcohol use (alcohol consumption> 80 grams per day for at least 5 years)
  • Symptoms of CMP (Left ventricular dilatation with low left ventricular ejection fraction),
  • Absence of other causes of dilated CMP (HT, valve disease, ischemic causes, etc.)

Treatment of the patient's nutritional deficiencies such as vitamin B12, B6 and folate; Electrolyte imbalances such as hypokalemia and hypomagnesemia need to be corrected. 

A multidisciplinary approach is required for comorbid conditions such as depression, liver disease, etc. Alcohol should be stopped or if this is not achieved, it should be reduced in cases. 

Even in the short term, left ventricular function has been shown to be better when alcohol is withdrawn. There is no specific marker that can indicate improvement.

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