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Reversal of dilated to hypertrophic cardiomyopathy after alcohol abstinence
12. Medizinische Abteilung, Krankenanstalt Rudolfstiftung, Vienna, Austria.
Insights
In hypertrophic cardiomyopathy, alcohol may cause reversible left ventricular dilation and systolic dysfunction. This condition can mimic dilated cardiomyopathy but may improve with abstinence.
Area of Science:
- Cardiology
- Internal Medicine
Background:
- Left ventricular dilation and systolic dysfunction occur in 14-16% of hypertrophic cardiomyopathy patients.
- These findings can be misdiagnosed as dilated cardiomyopathy.
- Reversibility of these changes in hypertrophic cardiomyopathy is not well understood.
Observation:
- A 35-year-old man with a history of heavy alcohol use and prior diagnosis of alcohol-induced dilated cardiomyopathy presented with normal heart size.
- He exhibited concentric left ventricular hypertrophy and mildly reduced systolic function.
- Diagnosis shifted to hypertrophic cardiomyopathy due to absence of other causes for hypertrophy.
Findings:
- Alcohol may induce reversible left ventricular dilatation and systolic dysfunction in hypertrophic cardiomyopathy.
- This suggests a potential environmental trigger for cardiac changes in hypertrophic cardiomyopathy.
Implications:
- This case highlights the importance of considering alcohol's role in hypertrophic cardiomyopathy.
- It suggests that abstinence may lead to reversal of cardiac dysfunction and dilation.
- Further research is needed to understand the mechanisms and long-term outcomes.
Abstract:
Left ventricular dilation and systolic dysfunction develop in 14-16% of patients with hypertrophic cardiomyopathy. Such findings may easily be misdiagnosed as dilated cardiomyopathy. It is unknown whether left ventricular dilatation and systolic dysfunction in patients with hypertrophic cardiomyopathy are reversible. A 35-year-old man had been a heavy drinker for 13 years and was abstinent for 1 year. Five years previously he suffered cardiac arrest and, based on echocardiographic, radionuclide, and cardiac catheterization findings, the diagnosis of alcohol-induced dilated cardiomyopathy was established. At presentation the heart was of normal size, with concentric left ventricular hypertrophy and only slightly reduced systolic function. Hypertrophic cardiomyopathy was diagnosed since no other cause for left ventricular hypertrophy could be detected. In hypertrophic cardiomyopathy, alcohol may induce reversible systolic dysfunction and left ventricular dilatation.