2022 Volume 71 Issue 4 Pages 759-764
The patient is a female in her 30s, who has been drinking large amounts of alcohol for more than 10 years. Transthoracic echocardiography (TTE) showed enlargement of the left atrium and left ventricle and diffuse wall motion decline in the left ventricle. In addition, severe mitral regurgitation and moderate tricuspid regurgitation were observed, IVC expanded, and respiratory fluctuation decreased. Alcoholic cardiomyopathy (ACM) was suspected on the basis of her history of heavy drinking and TTE findings, and she was instructed to stop drinking and start medical treatment. In a re-examination about two months later, she said that she had reduced her alcohol intake. Follow-up TTE showed that her left atrium and left ventricle shrank, and her wall hypokinesia improved. Mitral regurgitation and tricuspid regurgitation were also mild, and IVC respiratory fluctuations were good. ACM is a secondary cardiomyopathy and is characterized by dilated cardiomyopathy-like myocardial damage due to long-term overdose of alcohol. In Europe and the United States, it has been reported that alcohol is involved in 23 to 40% of cases showing dilated cardiomyopathy-like pathology, and that abstinence from alcohol or a decrease in alcohol intake improves cardiac function and prognosis. This patient was also suspected of having ACM because she suffered from myocardial damage due to long-term alcohol overdose, and her cardiac function improved after abstinence from alcohol. In addition, the left ventricle was enlarged again when she increased her alcohol intake again. ACM seems to change not only the heart size but also cardiac functions such as left ventricular contractility depending on alcohol intake, and when ACM is suspected, follow-up by TTE is considered useful.
