[Alcoholic heart disease].
Alcoholic heart disease is caused by a lifestyle in which alcoholics are continue to consume an excessive amount of alcohol over a long period of time. Total abstinence is a very effective way to treat them to prevent the development of the final stage of this disease. In contrast, repetitive drinking of massive amount of alcohol is very harmful and causes exacerbation of this disease. From our clinical studies, six candidates were nominated as symptoms of alcoholic heart disease, namely(1) tachyarrhythmias (incidence: 33%), (2) left ventricular hypokinesis(17%), (3) QT interval prolongation(17%), (4) hyperthickened LV wall(13%), (5) LV dilatation with pump failure: alcoholic cardiomyopathy(0.1%), and (6) sudden cardiac death (unknown %). In the beginning of alcoholic heart disease, the patient usually complains of no symptoms, and physical signs are quite poor. Ordinarily, either transient atrial fibrillation and/or left ventricular hypertrophy which is initially documented by electrocardiography or echocardiography is one of the first signals in the diagnosis. Without such early signals, an early diagnosis is impossible. To make a definite diagnosis of alcoholic heart disease, a clinical follow-up is by all means necessary. Improvement of cardiac function after total abstinence, it's worsening after drinking again, and again improvement after abstinence a second time is a diagnostic clue. In this follow-up study, electrocardiography and echocardiography were employed as important ways to gather date. In treatment, total abstinence is essential. To achieve this therapeutic goal, education of the patient is necessary, because approximately 70 per cent of patients with alcoholic heart disease fail to continue abstinence within two years even if they have good training.
Takehana
H
H
Department of Internal Medicine, Kitasato University School of Medicine.
Izumi
T
T
D002310:Cardiomyopathy, Alcoholic / Q000175:diagnosis / Q000503:physiopathology; D002317:Cardiovascular Agents / Q000627:therapeutic use; D003937:Diagnosis, Differential; D006352:Heart Ventricles / Q000473:pathology; D006801:Humans; D009206:Myocardium / Q000473:pathology; D011379:Prognosis; D013610:Tachycardia; D013695:Temperance; D016277:Ventricular Function, Left
D002317:Cardiovascular Agents