English summary: ALCOHOLIC CARDIOMYOPATHY - AN UNDERDIAGNOSED CAUSE OF HEART FAILURE?

Background Ethanol is a common etiologic factor of dilated cardiomyopathy, although the prevalence of alcoholic cardiomyopathy in Finland is unknown. Alcohol abstinence is a critical determinant of outcome in patients with alcoholic cardiomyopathy.

Methods All patients treated either for heart failure or dilated cardiomyopathy at Oulu University Hospital during 2004 were selected for the study. Their patient records were analyzed thoroughly in order to find cases likely to have alcoholic cardiomyopathy.

Results Alcohol consumption was rarely mentioned in the patient records. Not even a qualitative assessment of alcohol consumption was recorded in 57% of the study subjects. Alcoholic cardiomyopathy was the likely diagnosis in 18% of the patients with dilated cardiomyopathy, but this diagnosis was only specified in the patient records of 2% of the patients. In our study sample, 8% of patients younger than 70 years with heart failure probably had alcoholic cardiomyopathy.

Conclusions Alcoholic cardiomyopathy is underdiagnosed. However, the recognition and recording of excessive alcohol consumption as the main etiologic factor of dilated cardiomyopathy and strong recommendations for abstinence are essential in the treatment of these patients.