Alcohol and congestive heart failure.

Ethanol has a definite acute negative inotropic effect (decreased contractility). Also, chronic overuse may lead to decreased contractile function of the heart. The symptoms of congestive heart failure in these patients do not differ from any other cause of congestive heart failure. But, on the other hand, the prognosis quo ad vitam for alcoholics seems to be worse when compared with patients with dilated cardiomyopathy. Whether this is due to a more severe form of disease or difficulties to abstain from alcohol and follow medical prescriptions is, however, not clear. It seems that abstention is effective only up to a certain stage of disease. Ethanol interferes with a number of myocardial metabolic steps and cellular mechanisms. A single key factor for the development of cardiac insufficiency can, however, not be pointed out, although it is well known that ethanol interferes with lipid metabolism and fatty acid composition of sarcolemma, as well as the properties of the membrane function of the sarcoplasmic reticulum. Malnutrition and lack of certain vitamins has also been suggested to be important in the development of congestive heart failure in alcoholics.