Alcoholic cardiomyopathy is a disorder in which excessive, habitual use of alcohol weakens the heart muscle so that it cannot pump blood efficiently.

Drinking alcohol in large quantities has a toxic effect on heart muscle cells. Alcoholic cardiomyopathy is a form of dilated cardiomyopathy caused by habitual alcohol abuse.

Alcoholic cardiomyopathy causes the weakened heart muscle to pump inefficiently, leading to heart failure. In severe cases, the lack of blood flow affects all parts of the body, damaging multiple tissues and organs.

The disorder is most commonly seen in men ages 35-55 years old, but it may develop in anyone who consumes too much alcohol over a long period of time. Alcoholic cardiomyopathy may be identified as "idiopathic dilated cardiomyopathy," if the person's drinking history is not known.

Symptoms are usually absent until the disease is in an advanced stage. At that point, the symptoms occur due to heart failure and may include:

• Ankle, feet, and leg swelling
• Overall swelling
• Loss of appetite
• Shortness of breath, especially with activity
• Breathing difficulty while lying down
• Fatigue, weakness, faintness
• Decreased alertness or concentration
• Cough containing mucus, or pink, frothy material
• Decreased urine output (oliguria)
• Need to urinate at night (nocturia)
• Sensation of feeling the heart beat (palpitations)
• Irregular or rapid pulse

A health care provider will conduct a physical examination, which may reveal:

• Abnormal heart sounds
• Abnormal lung sounds
• Murmurs
• Irregular or rapid heartbeat
• Weight gain
• Swollen neck veins
• Enlarged liver
• Ankle swelling
• Low blood pressure

Alcoholic cardiomyopathy is usually diagnosed when chronic heavy drinking is discovered as a cause of the heart failure.

The following tests may reveal signs of heart failure:

• An echocardiogram may show enlarged heart chambers, leaking valves, or reduced pumping efficiency.
• An ECG may show signs of enlarged heart chambers or rhythm abnormalities (arrhythmias).
• A chest x-ray or chest CT may show heart enlargement, fluid accumulation in the lungs and valves, and reduced pumping function.
• A complete routine laboratory study is performed to measure the hormone B-type natriuretic peptide (BNP).
• Cardiac catheterization and coronary angiography may be done to rule out coronary artery blockages as the cause for dilated heart chambers and decreased pumping function.