[Alcohol and the heart].

Acute effects of alcohol on the heart manifest themselves haemodynamically as an increase of the left-ventricular pressure with decrease of the stroke volume, when the left-ventricular ejection fraction is reduced, on the basis of a disturbance of the systolic pumping function. The most important acute alcohol-conditioned metabolic disturbances of the myocardium are described. The disturbance of the systolic pumping function appearing after acute application of alcohol involves an increased need of O2 of the myocardium, which is tried to cover by means of an increased coronary blood supply. In patients with coronary heart disease in acute application of alcohol an increase of the hypoxic pain threshold develops without removal of the myocardial hypoxia. The chronic effect of alcohol on the heart may lead to an alcohol cardiomyopathy which should be defined more comprehensively, i.e. as every etiologically unclear disease of the myocardium and its function, for which cause a chronic alcohol abuse is found as the only reference. With the help of literature and of own findings is among others referred to the frequent provable disturbance of the systolic pumping function of the left ventricle and to the also frequent hypertonic regulation of the blood pressure in load in these patients. Apart from this, the symptomatology, clinic, therapy and prognosis of the alcohol cardiomyopathy are described, the pathogenesis of which are understood as multifactorial process and its full picture as terminal stage in the development of alcohol-toxic changes of the myocardium.