“Alcohol induces a number of pathologic changes to the heart. The classic manifestation is heart failure from dilated cardiomyopathy. Dilated cardiomyopathy is an irreversible process in which the ventricular wall thickness is normal but the ventricular chambers are enlarged, giving the appearance of thinned walls (shown). Patients have subsequent systolic dysfunction and are at risk for arrhythmias, thromboembolism, and sudden death. Holiday heart syndrome refers to the development of rhythm disturbances after alcohol use in patients without structural heart disease. Atrial fibrillation is the most common disturbance, and most cases are self-limiting.”