Heart Failure due to Alcoholic Cardiomyopathy in Young Men
Case Report
DOI:
https://doi.org/10.55175/cdk.v52i2.1341Keywords:
Alcohol, heart failure, alcoholic cardiomyopathyAbstract
Background: Alcoholic cardiomyopathy (ACM) is cardiomyopathy caused by consuming large amounts of alcohol. Diagnosis is determined based on alcohol consumption’s history, clinical, and supporting data. Case: Male, 29 years old, came with shortness of breath especially when walking, lying down, and waking-up at night. The patient has been consuming 4 bottles of “Flores wine”/day for the past 14 years. Physical examination showed BP 124/93, pulse 101 x/min, RR 24 x/min, left apex and parasternal area systolic murmur, basal rhonchi, and edema of both feet. Electrocardiography showed RAD, RAE, LBBB, and LVH. Chest x-ray showed cardiomegaly and minimal pleural effusion. Laboratory examination showed SGOT 986.2 U/L, SGPT 448.3 U/L, and electrolyte imbalance. TTE results showed global hypokinetics, all cardiac chambers dilatation, reduced LV systolic function (EF 21.6%), severe TR, and moderate-severe MR. Angiography results showed no stenosis in all coronary arteries. MRI result is similar to TTE without late gadolinium enhancement (LGE). Therapy given according to guided-directed medical therapies (GDMT). Conclusion: ACM is cardiomyopathy with highly variable objective findings. In-depth history regarding alcohol consumption is crucial and other possible causes must be excluded.
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Visseren FLJ, Mach F, Smulders YM, Carballo D, Koskinas KC, Back M, et al. 2021 ESC Guidelines on cardiovascular disease prevention in clinical practice. Eur Heart J. 2021;42:3227–337. DOI: 10.1093/eurheartj/ehab484.
Kemenkes. Survei kesehatan Indonesia (SKI) dalam angka. Jakarta: Kementerian Kesehatan RI; 2023.
Fernandez-Sola J. The effects of ethanol on the heart: Alcoholic cardiomyopathy. Nutrients 2020;12:1–18. DOI: 10.3390/nu12020572.
Manthey J, Probst C, Rylett M, Rehm J. National, regional and global mortality due to alcoholic cardiomyopathy in 2015. Heart 2018;104:1663–9. DOI: 10.1136/heartjnl-2017-312384.
Guzzo-Merello G, Cobo-Marcos M, Gallego-Delgado M, Garcia-Pavia P. Alcoholic cardiomyopathy. World J Cardiol. 2014;6:771–81. DOIi: 10.4330/wjc.v6.i8.771.
McDonagh TA, Metra M, Adamo M, Baumbach A, Bohm M, Burri H, et al. 2021 ESC guidelines for the diagnosis and treatment of acute and chronic heart failure. Eur Heart J. 2021;42:3599–726. DOI: 10.1093/eurheartj/ehab368.
Wikananda G, Ariawan E, Priadnyana A. A 41-years old male with alcoholic cardiomyopathy at Tabanan General Hospital, Bali-Indonesia: A case report. Intisari Sains Medis. 2019;10:516–20.
Akbar RA, Lirani EA, Hasan MRD. Alcohol induced cardiomyopathy in non-alcoholic society: A case report of determining the etiology of dilated cardiomyopathy. Sch J Med Case Reports. 2022;10:348–56. DOI: 10.36347/sjmcr.2022.v10i04.020
Arnett DK, Blumenthal RS, Albert MA, Buroker AB, Goldberger ZD, Hahn EJ, et al. 2019 ACC/AHA guideline on the primary prevention of cardiovascular disease: A report of the American College of Cardiology/American Heart Association task force on clinical practice guidelines. Circulation 2019;140:596–646. DOI: 10.1161/CIR.0000000000000678.
Ihekire NL, Okobi OE, Adedoye EA, Akahara PF, Onyekwere AO, Afrifa-Yamoah J, et al. Heartache in a bottle: Understanding alcoholic cardiomyopathy. Cureus 2023;15:1–12. DOI: 10.7759/cureus.42886.
Kałuzna-Oleksy M, Sawczak F, Kukfisz A, Krysztofiak H, Szczechla M, Wleklik M, et al. The impact of clinical, biochemical, and echocardiographic parameters on the quality of life in patients with heart failure with reduced ejection fraction. Int J Environ Res Public Health. 2021;18:1–14. DOI: 10.3390/ijerph182312448.
Wang S, Ren J. Role of autophagy and regulatory mechanisms in alcoholic cardiomyopathy. Biochim Biophys Acta - Mol Basis Dis. 2018;1864:2003–9. DOI: org/10.1016/j.bbadis.2018.03.016.
Shaaban A, Gangwani MK, Vindhyal VSPMR. Alcoholic cardiomyopathy [Internet]. NIH. 2023 [cited 2024 May 11]. Available from: https://www.ncbi.nlm.nih.gov/books/NBK513322/#:~:text=Alcoholic cardiomyopathy (ACM) is a,of non-ischemic dilated cardiomyopathy.
Piano MR, Phillips SA. Alcoholic cardiomyopathy: Pathophysiologic insights. Cardiovasc Toxicol. 2014;14:291–308. DOI: 10.1007/s12012-014-9252-4.
Ware JS, Amor-Salamanca A, Tayal U, Govind R, Serrano I, Salazar-Mendiguchia J, et al. Genetic etiology for alcohol-induced cardiac toxicity. J Am Coll Cardiol. 2018; 71:2293–302. DOI: 10.1016/j.jacc.2018.03.462.
Andersson C, Schou M, Gustafsson F, Torp-Pedersen C. Alcohol intake in patients with cardiomyopathy and heart failure: Consensus and controversy. Circ Hear Fail. 2022;15:805–12. DOI: 10.1161/CIRCHEARTFAILURE.121.009459.
Artico J, Merlo M, Asher C, Cannata A, Masci PG, De Lazari M, et al. The alcohol-induced cardiomyopathy: A cardiovascular magnetic resonance characterization. Int J Cardiol. 2021;331:131–7. DOI: 10.1016/j.ijcard.2021.01.067.
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