alcohol and sudden cardiac death

The relationship between alcohol and ischaemic heart disease is not straightforward – moderate intake appears to be cardioprotective, but ‘heavy’ intake is associated with a 2 fold increase in the incidence of sudden cardiac death, particularly in drinkers aged 50-59 years (Wannamethee 1992)

Heavy intake of >6 drinks daily has been shown to induce cardiac arrhythmias and Ventricular Tachycardia (VT). Evidence also exists with regard to binge drinking, where the following arrhythmias have been recorded (Ettinger 1978);

• Isolated ectopic beats
• Atrial fibrillation
• Paroxysmal atrial tachycardia
• Junctional tachycardia
• VT

Alcohol is also known to increase blood pressure, and conduction defects are known to be present in overt alcoholic cardiomyopathy. Sudden death is also associated with alcoholic fatty liver, although the precise mechanism for this remains obscure. (Hirsch and Adams 1993; Ettinger 1978; Sheppard and Davies 1998).

references

• Ettinger PO, Wu CF, De La Cruz Jr C, Weisse AB et al. Arrhythmias and the ‘Holiday Heart’: alcohol-associated cardiac rhythm disorders. American Heart Journal 1978 95(5): 555-562
• Hirsch CS, Adams VI. Sudden and unexpected death from natural causes in adults. Chapters 5 in ‘Spitz and Fisher’s Medicolegal investigation of death. Guidelines for the application of pathology to crime investigation.’ Spitz WU (Ed) (3rd Ed) 1993 Charles C Thomas Publishing, Springfield Illinois, USA
• Sheppard M, Davies MJ. Practical Cardiovascular Pathology. 1998 Arnold Publishing, London UK
• Wannamethee G, Shaper AG. Alcohol and sudden cardiac death. British Heart Journal. 1992 68:443-8