Alcoholic Heart Disease

Thirteen chronic alcoholic male patients with normal cardiovascular findings and minimal or no liver disease underwent right and left heart catheterizations. Cardiac pressures and cardiac outputs were obtained at rest and during exercise. An abnormal alteration in pressure or flow was demonstrated in 12 of the 13 subjects. Thirty minutes after the administration of 0.3mg. of ouabain a repeat exercise was performed. The abnormal rise in cardiac pressures observed in the pre-ouabain exercise state was now prevented. The cardiac index and stroke index fell in 6 patients while it rose in the other 7 patients. This varying response of the cardiac output is seen in normal subjects.Digitalis, with its positive inotropic action on the left ventricle, can prevent the rise in the cardiac pressures. This may have clinical application in preventing congestive heart failure in the alcoholic patient undergoing surgery or any type of severe stress.