Alcoholic cardiomyopathy, according to the existing classification, is a secondary disease and refers to the toxic form of dilated cardiomyopathy. It is characterized by selective myocardial damage due to prolonged abuse of alcohol.
The disease is considered quite common and makes up almost a third of all diagnosed dilated cardiomyopathies. This is an urgent problem in Russia and Europe, where most of the adult population consumes alcohol in small and moderate amounts, and about 10% in significant quantities. It is difficult to accurately determine the prevalence of the disease, since many deny the pathological addiction to alcohol. Alcoholic cardiomyopathy is the cause of death of about 10-20% of patients with chronic alcoholism.
The main development factors are a certain amount and duration of exposure of ethanol and its metabolites to the heart muscle. According to experts, people who take 100 ml of pure ethanol daily for 10-20 years are susceptible to the disease. About half of them develop alcoholic cardiomyopathy.
Symptoms
At the very beginning of the disease, stagnation and cardiac arrhythmias are observed, which are manifested by edema and shortness of breath during physical exertion. Patients, as a rule, categorically deny the fact that they abuse alcohol and do not associate the first symptoms with their addiction.
Alcoholic cardiomyopathy is characterized by the following classic signs:
General weakness, fatigue.
Feeling of heat.
Increased sweating.
Dyspnea and severe palpitations during exercise.
Constant pain in the heart.
At first, these symptoms appear only the day after drinking large doses of alcohol and are absent with abstinence. With the progression of the disease, sooner or later there comes a moment when these signs do not completely disappear and become permanent. Patients complain of severe shortness of breath and night
attacks of suffocation, which indicates the development of heart failure.
When examining a patient, you can observe typical signs of a person suffering from chronic alcoholism:
puffy red face;
a purple nose with dilated capillaries;
excited state, talkativeness, fussiness;
hand tremor;
limb cooling;
overweight or excessive thinness;
yellowness of the sclera;
Red eyes;
dyspnea at rest.
Examination of the patient reveals increased pressure, arrhythmia, tachycardia, muffled heart sounds , systolic murmur at the apex of the heart. Alcoholic cardiomyopathy can be accompanied by cirrhosis of the liver, erosive gastritis, gastric ulcer, chronic hepatitis, kidney damage due to the toxic effects of alcohol.
The disease develops gradually and has no symptoms for a long time. There are three stages.
The first lasts about 10 years. A person complains of a headache, palpitations, sweating, irritability, insomnia, shortness of breath, heart pain. At this stage, there is high blood pressure, tachycardia, but the heart muscle is not yet enlarged.
In patients with a history of alcohol abuse of more than 10 years, you can find signs such as puffiness of the face, blueness of the nose, ears, fingertips. Even with small loads, shortness of breath and coughing appear. The heart muscle enlarges, arrhythmia occurs, and heart failure develops.
In the third stage, cardiosclerosis progresses rapidly and irreversible morphological changes in the heart occur.
Who is sick
As a rule, alcoholic cardiomyopathy occurs mainly in men aged 35-50 who have been abusing spirits, beer or wine for at least 10 years. Women are less likely to get sick, but it takes less time to develop the disease, since the required dose of ethanol is about 60 ml, and their heart muscle is more sensitive to this type of toxin.
Alcoholic cardiomyopathy is more common in members of lower social strata who are usually poorly fed. The lack of vitamins and proteins plays a role in the development of the disease.