170 WHEN THE HEART GETS DRUNK

Abstract A 53-old male with arterial hypertension, obesity (BMI 32) and gout presented to our Emergency department symptomatic for dyspnea, complaining about reduced functional capacity (NYHA III), gain of weight e increased abdominal circumference. In the days after we discovered a history potus (2 liter wine/day). At first physical examination confirmed clinical features heart failure pulmonary congestion ascites. The EKG showed atrial fibrillation, 80 bpm. An echocardiogram severely ejection fraction (EF 23%) diffuse hypokinesia, left ventricular mass, deeply volumes, only slightly thickness, mild moderate diastolic dysfunction. Also, right was hypokinetic dilatated. During hospitalization patient underwent coronary angiography, which no lesion, cardiac RMN pathological in both T1 T2 weighted sequences. No uptake contrast LGE sequences evidenced. We started diuretic therapy optimized improvement. management anticoagulant difficult because hepatic dysmetabolic cirrhosis (Child-Pugh Score 8, class B) contraindication DOACs treatment. Moreover performed gastroscopy, evidenced an ulcerative gastro-duodenitis erosive gastritis confirming temporary contraindication. discharged hemodynamic stability, wearable defibrillator taken charge by multidisciplinary team. After normalization function anticoagulation longer forbidden so three weeks proceeded successful electrical cardioversion. 6 months almost completely recovery systolic 62%) reduction chamber dilatations. denied alcohol consumption throughout period. This case demonstrates that alcoholic cardiopathy if it's diagnosed at beginning can be partially reversible. presents challenging setting due frequent comorbidities requiring approach. Achieving significant compliance is also crucial long term lifestyle changes.