Abstract
Alcohol is a commonly consumed and enjoyed commodity within the global population today. Despite a purported reduction in coronary artery disease with moderate alcohol use, chronic excessive alcohol consumption can lead to deleterious health effects. While mainly associated with liver disease, injury, and mental health, it can also have devastating effects on the cardiovascular system, such as heart failure, sudden cardiac death, and stroke. More than 280 million people worldwide are currently diagnosed with alcohol use disorder. Alcohol and its metabolites exert both direct and indirect toxic effects on myocardial tissues and can lead to myocardial cell damage, apoptosis, fibrosis, and progressive myocardial dysfunction, specifically dilated cardiomyopathy. We present the current epidemiology and incidence, outline the major toxic effects of alcohol and why they occur, discuss the current guideline-directed treatment strategies, and propose targets for possible therapies in the future based on pathophysiology.