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alcohol and the heart
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alcohol and the heart

Hello.  I am 37 years old, female diagnosed with mitral valve prolapse at age 19.  I had an echo about a year ago and the only thing that showed up was a slightly lower EF - 47%.  The doctor asked me how much alcohol I consume, and I told her 3-4 glasses of wine per day.  She said that this is too much, and could be weakening my heart.  My questions are these:  I thought a person had to be an alcoholic (i.e. drink all day every day, or close to it) to get alcoholic cardiomyopathy.  Is this not true?  How much alcohol is generally considered safe for the heart?  Could there be some other cause, possibly a bad bout of the flu that I had a couple years ago which caused this weakining?  Anything you can tell me about the effects of alcohol on the heart would be greatly appreciated.

Thanks,
Skye
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Dear skye,

Alcoholic cardiomyopathy can occur with only moderate consumption of alcohol on a regular basis over a prolonged period of time.  Most studies that show caridac benefits to alcohol show the most benefit with about 1 drink a day.  I would tend to agree with your doctor that you should consider a trial period off alcohol and see how your heart does.  It is possible that you may have a viral cardiomyopathy but it is difficult to prove.  If you have an improvement of your cardiac function off the alcohol you will have your answer.
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Avatar_n_tn
Hi Skye,

I am impressed that you doctor asked the question.  Many doctors are not very informed about alcohol and avoid challenging their patients on alcohol usage.

I have read a lot about heart disease and alcohol.  I too drank 3 to 4 drinks almost every night and was suprised to find out that much is considered heavy drinking from a medical standpoint.

I think that 1 glass of red wine each night might be heathful, but anything more is not.  

I found that I had settled into the 3 to 4 drinks per night habit and couldn't cut back to one drink.  I just craved it too much.

Although I didn't think that my life was otherwise being negatively impacted by alcohol, I did come to the conclusion that I was a maintenance alcoholic because of my need to drink those 3 or 4 drinks nearly every evening.

My solution was to quit completely with the help of AA.  It hasn't been easy to not drink at certain times, like when sitting down to dinner in a restaurant, but I do think that it was harmful to my health.  

I also had thought that I enjoyed that nightly buzz and that it calmed my anxiety, but I now value having a clear mind more and find that the anxiety was a cycle perpetuated by alchohol.  Also my brain works a lot better and I have more energy.

If you can't cut back to 1 drink a couple of times per week, you probably have developed a habit.  In that case, it would be easier to quit completely than constantly struggling with it.  

You don't have to do it alone.  Find AA in the phone book and make that call to find out when there is a meeting near you.  You will be surprised at the people that you find there.  Men and women from all walks of life, who have had that problem to one degree or another - Those that were alcoholics as you describe them and also those who were barely potential alcoholics.





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Avatar_n_tn
Thanks so much for your thoughtful response.  I have been using alcohol since I was 21 (when I lost both of my parents 4 months apart, of separate causes) when I began developing social anxiety disorder.  Without some type of relaxant I find it very hard, and sometimes impossible to live any kind of normal life, such as eating out in restaurants, going to parties, etc...  Alcohol is easy because it is so often present in social situations.  Because of this disorder, going to an AA meeting would never be an option for me unless I pre-medicated.  I have read that panic attacks and mitral valve prolapse often go hand-in-hand.  Maybe the doctor could shed some light on this?  I don't want to end up killing myself with the alcohol, but my only alternative seems to be use of benzodiazapines, which are also addictive.  I have a beautiful 9 year old son and a husband who loves me dearly.  I would consider it a miracle if I could find a way to be a real person in their lives, and not someone who interacts well only behind a wall of self-medication.

Thanks so much for listening.

Skye
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Avatar_n_tn
Alcohol can be used to cope with anxiety, but it also causes anxiety.  You get into a daily cycle from which alcohol provides only temporary relief.

I don't think that AA is what you think it is.  I go to a 7AM meeting in my neighborhood which only has a few people and is very informal.  It helps me get started on the right track each day and really calms me.

It's not a matter of having to get up in front of a group of people or anything like that.  Also there are many people there that have suffered from anxiety disorders and depression.  It all goes along with alcohol.

I think that if you could take the first step and call them and go to a women's meeting, it might help you to change your life.  See if you can find an older woman there with some time in the program to be a temporary sponsor.  The right person can really help.

I do hope that you can take that first step.  I know that there is a time in life when we all realize that we have to find a way to move on.  

Best Wishes,

Bill


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Avatar_n_tn
I have found these points very interesting as I have been wondering myself if the 3 glasses of wine each evening with my meal were excessive. When I first started on heart meds, I asked my doc if it was OK to have wine and he seemed to think it would do no harm. Also my husband encourages me to share a bottle with him as he has heard that it is good for the heart, and I don't get many treats being on a very low fat diet.( Also he enjoys the wine but would not drink by himself, so has a vested interest in encoraging me )  Recently I have been wondering if the palpitations I have been getting at night have been due to the alcohol and reading your posts have encouraged me to give up at least for a week or two to see if I feel any better!! If nothing else it will save some cash as it is quite expensive here in the UK.
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I do know personally that arythmias are aggravated by alcohol.  I have some damage from my 100% occluded RCA.  I experienced PACs or PVCs quite often after drinking.  It is extremely rare that I feel any skipped beat or palpitation now that I abstain from alcohol completely.

I do think that a glass of red wine each evening might be beneficial to the heart.  If I could drink only that one glass without wanting more, I probably would have continued drinking.
If I am drinking wine, I generally want to finish the bottle, which is only a few glasses.  If I am drinking beer, I am not satisfied until I have had 3 or 4 strong beers.

Part of coming to the decision not to drink at all, was coming to a belief that there was high value to always being in an unaltered conscious state.  I did enjoy that evening buzz and the warm and fuzzy feeling of having my conscious state altered by alcohol, but there are dividends to never altering it, if that makes any sense.

Also, I have regained a lot of mental ability, since discontinuing alcohol.

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Avatar_n_tn
Dear Skye
I also had a problem with drinking wine that landed me in the hospital with aterial fibrilation. I had been useing alcohol for 27 years. I knew I could not continue, but I also knew that AA was not for me!!I searched the internet and found a site called "SMART RECOVERY". It is a wonderfull site with lots of people there to help. NO FACE TO FACE meetings are required,but there are some in some places. There are ON LINE meetings that you can attend. Also there ia a message board that you read,you can post what you are feeling or just read what applys to you. It has helped me through a very tough time. I have NOT HAD A DRINK since last July, and feel very good about myself.

You can find them at WWW.SmartRecovery.com.
My Email Addy is ***@**** If you would like to write to me.
Good Luck Kiddo................Regards Kathie Franklin
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Avatar_n_tn
Do you think that it is possible to have a few drinks now and then (say at the weekend ) or is it best to keep off it altogether?
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Avatar_n_tn
I don't think there is any harm in having a couple of drinks from time to time if you don't have to fight a daily desire to drink or fight a desire to drink more than a couple.

The problem that I have is that I settle into a habit of drinking 3 to 4 strong beers nearly every evening and that's pretty tough on a heart condition.

On the way home from work, I have built up some anxiety, and I am thinking that I should stop at the mini-market and buy a six pack.

The only way for me to deal with it, that works for me, is to abstain from alcohol completely and go to AA meetings to maintain my resolve not to drink.

Otherwise I need to be constantly dealing with the desire to drink in the evenings, at dinner, while camping out, etc.  By the way I have the same problem with other things.  If I have chocolate in the house, I will eat it.  If I have cookies they won't last the night.  I just don't buy that stuff, but I have to force myself to walk by it in the supermarket.

If you go out and have 3 or 4 drinks and it causes arrythmia, you will have to decide if it's worth it.  I got used to the arrythmia when I drank and just accepted it.  I don't think that's very smart, but I didn't think that it would kill me.

I don't think that everyone who drinks a few drinks regularly is an alcoholic and needs to go to AA.  On the other hand, there is a great deal of denial around alcohol usage, and if a person thinks that they might have a problem, they should try to do a thorough and honest evaluation of how much alcohol is affecting their life and health.

When a person's doctor, friend, or family dares to bring the subject up, it's probably better to examine and discuss the situation rather than be defensive about it, although it would be my natural response to be defensive.




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Avatar_n_tn
I can sympathise with you over the chocolate and cookies! If I have any in the house - I sometimes buy them, for the grandchildren of course, but even as I am buying them I know I will eat them myself . Once I have started on them I can't stop even though I am on a very low fat diet and cholesterol lowering meds as my arteries are so bad that any further blockage could be fatal.Am being quite good at the moment not buying anything that is not "healthy"   I stayed off the wine for a week and guess what? I have lost 3lbs in weight!
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Avatar_n_tn
Hi Chris,

Don't know if you are still following this thread or not.  I just checked back today after not turning on my computer since Friday.

Good for you on abstaining for a week.  It does add a lot of empty calories.  I liked strong beer.  When you drink 3 or 4 of them 5 or 6 nights per week, it's a lot of calories.

Do you know that the French have developed a pill with all of the benefits of red wine?  I am trying to get them in the U.S., but haven't been successful yet.  I do take Resveratol, which is similar.

Coronary artery disease can be halted and reversed.  I suspected that I had a problem earlier, but it was confirmed when I had a heart attack 2 years ago.  An angiogram at that time showed a 100% occluded RCA and a 70% occluded circumflex, neither of which could be addressed with angioplasty.

I now have a good program of cholesterol control, and may have stopped the progression of the disease, but it took me over a year to get on the right drugs and fine tune my program.  In that time a plaque in my left main ruptured and decreased my ability even further.  After that the doctors gave me a 40% chance of sudden death within the next five years because I refused bypass surgery.  I think this was due to successful lipid reduction and was actually progress.  

I have knocked my total choleserol down from 220-240 to 141 on the last checkup.  My LDL was 77 on the last checkup.  

The reason for that is simple: Drugs!  I am on a combination of Lipitor and Welchol (a relatively new bile binder).  I also take and ACE inhibitor (Altace), which I think is very beneficial for someone with advanced CAD.  If I had been satisfied with what my doctors initially perscribed, I doubt that I would be getting these numbers.

Studies here at the University of Washington have shown that the Statin-Niacin combination stops atheriosclerosis in almost everyone and reverses it in many people.  I am contemplating adding Niaspan to my drugs, but had been hesitant because of potential liver problems.

It's also extremely important to get daily exercise.  I walk a hilly course twice per day.  The hills are important because they work your heart.  I also hike and climb on the weekends.  This last weekend I took it easy with 1 hike of about 2,000' elevation gain and a second of about 1,500'.  I have an active climbing schedule this summer.  I can climb almost anything one step at a time - it just takes me longer than people with normal heart function.  I'm climbing 3 of the volcanoes here in the Pacific Northwest this summer and a mountain in Montana next month.

I also think supplements are important.  I put back in some good oils: salmon oil and and omega3 mix.  I think that a B-Complex, Vitamin E, and Folic Acid are important.  I don't know if Garlic helps, but I take about 8 of the odorless tablets each day.  I take a bunch of other stuff, but won't go into it.

Also attitude is very important.  I try to work at keeping a positive and grateful attitude these days.  Every day above ground is a great day, when you are faced with this potentially life threatening condition.  Negativity and anger are killers.

When you have coronary artery disease you have to walk a narrow line to stay healthy and hold the disease at bay.  You need the right drugs, supplements, exercise, and attitude.  You need to practice everything daily if you want to feel normal most of the time and stay away from the surgeon's knife.

Good Luck,

Bill






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I found your reply very interesting. I do not have the option of surgery because  angiography at the start of the CAD 5years ago showed so many blockages and damage that I was considered inoperable, though I had been hospitalised for emergency surgery because of unstable angina.Apparently the arteries could deteriorate rapidly at any time  and my husband was told I could last up to 3 years - it is nearly twice that now -so looks as tho the statins are doing a good job.
  I am on the usual medications but my exercise capacity is very limited - hills are definitely out and I do miss the cycling. I have been doing a bit of gentle swimming at weekends. I am on Atorvastatin 20mg and very low fat diet plus beta blockers, aspirin, nitrates, calcium channel blockers, diuretics. I am trying to suggest ACE inhibitors but the docs do not seem to think so,
Good Luck with all your adventures!!  we did go camping (with tent)in the Alps last year for a few nights just to see the scenery -not to far to drive from the UK ,
Chris
  Thanks to the person starting this thread I have been following it with interest!
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Avatar_n_tn
Hi Chris,

Congradulations on surviving against medical opinion.  You may be able to return to perfectly normal health within a few years and really mess up their predictions.

I don't know your age, but for some women, I have read that the general constricting of all of the coronary arteries is a consequence of menopause and not atheriosclerosis.  In some it can be reversed with hormone therapy.

Here is an article from Heart Info:

http://www.heartinfo.org/reuters2001/010307elin024.htm

(you may have to cut and paste this to your address line).

There are many more articles on this there.  You can search for them.

Swimming is good exercise.  If you could increase that to several days per week it would help.

My experience with beta blockers is not good.  If you don't have a rhythm problem, perhaps you could get your doctor to wean you off the beta blocker and put you on an ACE inhibitor like Altace or Zestril.  I don't think beta blockers are a good choice for healthy people without rhythm problems.  If you want to exercise back to health, they are counterproductive.

Also, if you can wean yourself off of nitrates it might be good.  I don't think that constant NO stimulation from something like Imdur is good for someone healthy who is trying to condition their heart via exercise.  I carry regular nitro, for an emergency, but never have used it.

I don't take any drugs that detract from being a normal, active, healthy human being.  That includes beta blockers, nitrates, and blood thinners, although aspirin is good if you can take it.  Other supplements like Vitamin E and Fish Oil can help keep your platelets from aggregating.

If you still have elevated lipid levels, you might try a combo therapy such as Lipitor + Welchol or Lipitor + Niaspan.

I also take a low dose calcium channel blocker (Norvasc).  Supposedly it's beneficial to smooth muscle.

I do experience angina if I warm up too fast or exercise after eating.  I don't exercise through angina, but try to stay below the threshold where it kicks in.  If I feel a little tightness, I stop for a few moments.  After 20 minutes of warmup, I develop a fairly high ability to exercise without angina.  I just keep pushing it back every day.

I also don't let doctors determine my fate by withholding a drug that could be beneficial.  There are many doctors with different favorite drugs and some of them don't keep up.

Best wishes and good health,

Bill


  

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Hello Bill,
Thanks for all the info!
I am 61 now and had a hysterectomy at age 35 - was not put on HRT as it didn't agree with me. Not so much choice all those years ago, or so much known.Could perhaps have prevented the oseoporosis I now have, also.
Heart disease is in my family on both sides -my father died at age 38 and all his many brothers and sisters had heart problems.
My younger brother has just had sucessful bypass surgery. The others are all being vigilant!
Just out of interest - how many pills do you take a day? It must be a fair few!!
Thanks for your help,
Chris
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Avatar_n_tn
Hi Chris,

Unfortunately I am also subject to heredity - a familial HDL deficiency.  My mother had several heart attacks, bypass surgery, and died at 64 of heart failure.  Of course I ate too much fat, didn't exercise enough, and was a workaholic, which is pretty stupid now that I look back at it.

Yes, I take about $425.00 US of meds and $200.00 of supplements each month.  I don't know which, if any, of the supplements help, but I think that it's important to believe that some of them may be helping.

I'm also taking the Linus Pauling Vitamin-C regimen.  There was just a scare in the U.S. press that too much Vitamin-C may cause DNA damage, potentially leading to cancer, but I plan on continuing at least through the summer to see if it has any effect on my existing left main lesion.

For perscription meds I take:

Lipitor
Welchol
Norvasc
Altace

I'm contemplating adding Niaspan to boost HDL levels.  I can't take aspirin because of a severe allergy to it.  I Refuse Beta Blockers, Blood Thinners, or Diuretics

Supplements include:

Multi-Vitamin
Vitamin A
Vitamin B Complex

Vitamin C 6-8 grams x 5 days per week
L-Lysine  4 Grams x 5 days per week
L-Proline 1 Gram x 5 days per week

Vitamin E 800 iu
Folic Acid  800 iu

L-Arginine
L-Carnitine
L-Taurine

Cayenne
Garlic (lots of it)
Salmon Oil (2 grams)
Omega-3 Tonic

Green Tea
Resveratol
Lycopene
Hawthorne

I have added and discarded various supplements over the years, like Co-Q10, which I didn't see any value in.  Most of this just becomes a belief system.

The main part of my program is daily exercise.  In my case walking up and down hills, but daily swimming could even be better.  I walk about 20 miles during the week and at least another 10 on the weekends.  I probably go up and down about 5,000' per week.

Anyway, I am not a fan of stents or bypass surgery and am willing to risk the 40% chance of sudden death prognosis that I have been given, because I just feel too well and capable.  I think that it takes many years to develop coronary artery disease and it takes a couple of years to stop it, even if you do everything correctly, and perhaps many years to reverse it.

Best of luck to you,

Bill





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