alcoholic cardiomyopathy - Heart Disorders Message Board

wildpikey · 07-31-2006, 11:13 PM

Im a 35 year old guy whos always been very fit and don't smoke.

I must admit though i do drink very heavily on occations , (binge drink episodes)

I have recently been for an annual check up and everything was fine except for i had a heart murmur.

On further checks it was discovered that i had a mild leak in my mitral valve, my LA and LV chambers were slightly enlarged and the heart wall was slightly thickened.

After stress test etc, the advise of the doctor was not to worry, and carry on the way i was.

Since then however, i have been worried sick and researching the internet to find out more information.

I have cut down drinking, but i still train hard in the gym, sometimes i feel a bit light headed.
any advise as to what progress may be made, still train hard? drink? etc.... is damage that has already been done reversible???

started04 · 08-01-2006, 09:33 AM

Hi Wildpikey,

An enlarged heart and wall thickness indicates (usually) the heart is compensating and overworked due to a cardiovascular problem. Unless the size is NORMAL for you, it is generally not normal and should be treated. My heart size returned to normal after taking medication to dilate vessels (reduce hypertension and heart rate) and as the workload for the heart was reduced so was size.

Many people who drink alcohol excessively have an abnomally enlarged heart! I'm not sure of the physiopathology but it may be due to damage artery walls causing the heart to work harder or it may place a higher need for more oxygen for a period of time and the heart does not return to normal between episodes of drinking. Also, if in a smoking environment, there can be damage to artery walls and then heart problems. Whether or not your heart size can be reduced depends on the underlying reason...a large person and/or athlete may have an enlarged heart with strong contractions that is more than adequate to meet the body's need for oxygen rich blood.

For some perspective, the reason for an abnormally large heart size and wall thickness is an attempt to meet oxygen demand by increasing capacity and elasticity (contractions) are stronger. But as it continues to enlarge there is point when elasticity decreases ( i.e. same as stretch a hand spring and it snaps back, but to over stretch it becomes inflexible) and cardiac output decreases causing heart failure.

A minor leak of the MV may be insignificant, but should be monitored.

Beefsteak · 08-02-2006, 12:04 AM

Ken, I too have wondered about the enlarged heart problem.
I've not seen any reference to alcohol causing this problem directly, but would be interested to read about it.
More generally, I think there must be something else to the story because otherwise athletes would have problems too, caused by the increased demand by their bodies for oxygen. Guessing - it might be that, in a diseased body, the increased oxygen demand causes the heart to enlarge but the vascular system is relatively fixed - specifically the walls of arteries around the heart. The result then would be an even greater imbalance between the size of the heart and the capacity of the arteries supplying the necessary blood.
Only last night I glanced at the back of my hands and was amazed how pronounced the arteries and veins were, and how they had responded so quickly. These have developed since I started my stronger exercise routines just a few months ago. If I achieved anything like that in the arteries around my heart I would be in great shape. So, based on this thin logic, it's the inflexibilty of the cardiovascular arteries and their lack of any capacity to grow and meet the demands of the new heart, that causes the problem. Unfortunately the plague does not deposit evenly in the arteries but centres on the cardiovascular system - why this is I do not know.

It's interesting that some recent research in Australia has shown that plaque can be detected on the arteries of children as young as 6, and the plaque can be gradually removed by a steady exercise routine (the plaque was found in those that did not exercise). At this age the arteries are of course growing and very flexible. Keeping them flexible prevents the plaque buildup.

Wildpikey, Unfortunately you cannot compensate for the binge drinking by working out more in the gym. You must break the pattern and the first step you have made, which is to recognise there is a problem, is quite positive.
I am much older than you but I had a choice of gradual destruction through alcohol or trying at least to achieve something better in my life. The statistic that got me was that 30% of men over 60 that enter hospital do so because of alcohol-related diseases. I could see where I was headed - I chose not to go down that path. I got up to the point of deciding to attend an AA meeting
when I gave up.
Hypnosis is a powerful technique that can help you in that - don't be afraid to use it.
Beefy

Lenin · 08-02-2006, 07:24 AM

Quote:

Originally Posted by wildpikey

my LA and LV chambers were slightly enlarged and the heart wall was slightly thickened.

After stress test etc, the advise of the doctor was not to worry, and carry on the way i was.

pikey,

Call your doctor and get the meaning of his use of the term "slightly"...ask him frankly if he would judge that you are suffereing cardiomyopathy.
If he says NO, then forget all about it. If he says YES then tell him you want your ejection fraction measured.

It's likely there's no reason to worry because normal heart size follows a bell curve distribution and very few people are smack dab in the middle. Even bigger people tend to have bigger hearts and exercise can thicken a heart wall.

I think the cardiomyopathy from drinking is overamplified a bit, especially in countries with Victorian attitudes. It occurs, but it's not rampant. Far more dangerous is the effect of long term alcohol abuse on the LIVER...and alcoholic dementia isn't pretty.
If anything, the evidence might point to the cardioprotective aspects of drinking, even very heavy drinking...though nobody wants to go out on a limb with this theory.

Alas, until somebody can remove the calories from alcohol, I must remain almost a teetotaller myself.

started04 · 08-02-2006, 10:15 AM

Beefy,

You have an interesting theory.

My take on the matter is that an athlete's heart has muscular and better contractility of the heart's wall, and as a consequence has superior ability to meet the demand for oxygen with less effort when needed and at rest fewer heart beats to meet demand.

There may be a connection between alcohol and muscle tone and muscle tissue fibers. Rather than an artery problem it may be the athlete's heart has strong, connecting tissue fibers from exercising (the same with skeletal muscles), and excessive drinking may deteriorate heart muscle tissue causing the heart to enlarge to compensate for less contractility to pump blood with each heart beat. Maybe a fat heart!