Effects of Alcohol on the Heart: Current Views

Chronic and heavy alcohol consumption has deleterious effects upon the car-diovascular system and may cause congestive cardiomyopathy. Evidence of car-diac malfunction has been found in chronic alcoholics without overt heart fail-ure by invasive and noninvasive methods. Ethanol is the incriminated factor having a direct cardiotoxic effect. Elec-tron microscopy and cardiac muscle biopsies show that ethanol may cause changes on plasmalemmal, mitochondrial, and sarcoplasmic membranes. The clinical picture and general management of alcoholic cardiomyopathy do not differ substantially from those of congestive cardiomyopathies of any type. It has, however, been demonstrated that cessation of alcohol consumption may lead to an improved prognosis, even to restoration of normal cardiac func-tion, in individuals with preclinical and mild manifestations of cardiac dysfunc-tion. The literature on the possible association of coronary heart disease with alco-hol seems to be ambiguous. It has, however, been postulated recently that mod-erate alcohol intake may have a protective role against coronary heart disease, in contrast to alcoholic intemperance, which may be a factor favoring coronary heart disease