Although coronary disease risk is decreased by alcohol consumption, excessive alcohol use also impairs cardiac muscle function. Episodic heavy drinking bouts can lead to arrhythmias in the 'holiday heart' syndrome. Chronic alcoholics are prone to left-sided heart failure secondary to decreased mitochondrial function of cardiac muscle cells, possibly mediated by abnormal fatty acid metabolism. A specific form of high output heart failure, or 'wet beriberi,' occurs in association with thiamine deficiency.

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