Alcohol-Induced Cardiomyopathy: More than just a few drinks

Excessive alcohol consumption can leave a lasting mark on the heart—and not just after the holidays. While “holiday heart syndrome” may bring to mind temporary arrhythmias after a weekend of indulgence, chronic heavy drinking can cause more insidious, long-term damage.

What Is Alcohol-Induced Cardiomyopathy?

Alcohol-induced cardiomyopathy is a type of myocardial dysfunction resulting from long-term, excessive alcohol intake. According to the CDC, heavy drinking is defined as consuming more than 8 drinks (approximately 114 grams of pure alcohol) per week for women and more than 15 drinks (about 210 grams) per week for men. However, studies suggest that sustained intake exceeding 80 grams per day—roughly equivalent to six standard drinks daily—for five or more years significantly increases the risk of developing ACM. The most common clinical manifestation is dilated cardiomyopathy, characterized by enlargement of all four chambers, most notably the left ventricle, along with progressive decline in systolic function. ACM most frequently affects males between the ages of 30 and 55.

However, ACM exists along a spectrum. In early stages, the myocardium may still appear normal in size but may exhibit subtle dysfunction, reduced strain, or increased susceptibility to arrhythmias. ACM is classified under non-ischemic cardiomyopathies and is often a diagnosis of exclusion, supported by clinical history and imaging findings.

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