Definition: A diffuse disorder of heart muscle seen in individuals with a history of hazardous consumption of alcohol, usually of at least 10 years duration. Patients typically present with biventricular heart failure; common symptoms include shortness of breath on exertion and while recumbent (nocturnal dyspnoea), palpitations, ankle oedema, and abdominal distension due to ascites. Disturbance of the cardiac rhythm is usual: atrial fibrillation is the most frequent arrhythmia. Alcoholic cardiomyopathy should be distinguished from beri-beri heart disease and from a form of “beer drinkers’ cardiomyopathy” caused by cobalt poisoning. Synonym: alcoholic heart muscle disease.