Alcoholic Cardiomyopathy Managed with Prolonged Bed Rest

The influence of complete prolonged bed rest on the clinical course of 48 patients with alcoholic cardiomyopathy was studied. Heart size returned to normal with bed rest in 21 (57%) of the 37 patients who cooperated fully, decreased considerably in 11 (30%), and did not change in 5 (13%). Of the 21 patients whose heart size returned to normal, 13 (62%) are presently living, 9 (43%) with normal heart size. Of the other 27 patients only 10 (37%) are known to be presently alive, none with normal heart size. Response to bed rest therapy and long-term prognosis apparently are affected by duration and severity of the heart disease at the time bed rest is instituted. Unfortunately, the ultimate prognosis in many patients is poor because of delay in diagnosis, unwillingness to accept prolonged bed rest therapy, inability to refrain from alcohol consumption, inadequate nutrition, and excessive physical activity.