Best initial management for alcoholic cardiomyopathy?

Best initial management for alcoholic cardiomyopathy?

• A. High-sodium diet
• B. ACE inhibitors only
• C. Abstinence from alcohol
• D. Beta-blocker therapy

Answer: (C)

Stopping alcohol is the most important first step because ongoing ethanol exposure continues to injure the myocardium. When the toxin is removed, the heart has a chance to recover some function, and symptoms often improve over weeks to months. After abstinence, treat the heart failure with guideline-directed therapies as needed (for example, ACE inhibitors, beta-blockers, and diuretics) to support recovery and prevent progression. High-sodium diets would worsen heart failure symptoms, and while medications like ACE inhibitors or beta-blockers are important, they work best once alcohol exposure has been stopped.

Stopping alcohol is the most important first step because ongoing ethanol exposure continues to injure the myocardium. When the toxin is removed, the heart has a chance to recover some function, and symptoms often improve over weeks to months. After abstinence, treat the heart failure with guideline-directed therapies as needed (for example, ACE inhibitors, beta-blockers, and diuretics) to support recovery and prevent progression. High-sodium diets would worsen heart failure symptoms, and while medications like ACE inhibitors or beta-blockers are important, they work best once alcohol exposure has been stopped.