Alcoholic cardiomyopathy medical therapy

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Alcoholic cardiomyopathy Microchapters


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Differentiating Alcoholic cardiomyopathy from other Diseases

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Raviteja Guddeti, M.B.B.S. [2]; Hardik Patel, M.D.


Treatment for alcoholic cardiomyopathy involves lifestyle changes, including complete abstinence from alcohol use [1][2][3][4], a low sodium diet, and fluid restriction, as well as medications. If the heart failure is severe, the effectiveness of treatment will be limited.

Medical Therapy

Abstinence from Alcohol

Several studies have shown that abstinence from alcohol, if attempted prior to the onset of fibrosis, resulted in significant improvement in LV function [5][6].

  • Demakis et al followed 57 patients with alcoholic cardiomyopathy for over an average of 40.5 months to study the natural course of the disease. It was concluded that a short duration of symptoms before initiation of therapy and abstention from alcohol were associated with a more favorable course [7].
  • An echocardiographic study by Masani et al to found an improvement in the left ventricular ejection fraction left ventricular end diastolic dimensions in patients with alcoholic cardiomyopathy if alcohol intake is completely stopped [2].

Acute Pharmacotherapy

  • Prophylactic pharmacotherapy with beta-blockers, ACE inhibitors/angiotensin II receptor blockers coupled with abstinence from alcohol have been proven to halt or reverse the pathophysiology in asymptomatic LV dysfunction.
  • Treatment of arrhythmias in alcoholic cardiomyopathy should be addressed in the usual way.
  • Concomitant prevalence of nutritional deficiency is common in alcoholic cardiomyopathy. Therefore, supplementation with thiamine (200 mg once daily), vitamin B-12, folic acid and minerals should be attempted.


  1. Guillo P, Mansourati J, Maheu B; et al. (1997). "Long-term prognosis in patients with alcoholic cardiomyopathy and severe heart failure after total abstinence". The American Journal of Cardiology. 79 (9): 1276–8. PMID 9164905. Unknown parameter |month= ignored (help)
  2. 2.0 2.1 Masani F, Kato H, Sasagawa Y; et al. (1990). "[An echocardiographic study of alcoholic cardiomyopathy after total abstinence]". Journal of Cardiology (in Japanese). 20 (3): 627–34. PMID 2131353.
  3. Agatston AS, Snow ME, Samet P (1986). "Regression of severe alcoholic cardiomyopathy after abstinence of 10 weeks". Alcoholism, Clinical and Experimental Research. 10 (4): 386–7. PMID 3530014. Unknown parameter |month= ignored (help)
  4. Mansourati J, Forneiro I, Genet L, Le Pichon J, Blanc JJ (1990). "[Regression of dilated cardiomyopathy in a chronic alcoholic patient after abstinence from alcohol]". Archives Des Maladies Du Coeur Et Des Vaisseaux (in French). 83 (12): 1849–52, discussion 1853. PMID 2125195. Unknown parameter |month= ignored (help)
  5. Renault A, Mansourati J, Genet L, Blanc JJ (1993). "[Dilated cardiomyopathies in severe cardiac failure in chronic alcoholics: clinical course after complete withdrawal]". La Revue De Médecine Interne / Fondée ... Par La Société Nationale Francaise De Médecine Interne (in French). 14 (10): 942. PMID 8009044.
  6. Nethala V, Brown EJ, Timson CR, Patcha R (1993). "Reversal of alcoholic cardiomyopathy in a patient with severe coronary artery disease". Chest. 104 (2): 626. PMID 8339663. Unknown parameter |month= ignored (help)
  7. Demakis JG, Proskey A, Rahimtoola SH; et al. (1974). "The natural course of alcoholic cardiomyopathy". Annals of Internal Medicine. 80 (3): 293–7. PMID 4273902. Unknown parameter |month= ignored (help)

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