Best initial management for alcoholic cardiomyopathy?

• A. High-sodium diet
• B. ACE inhibitors only
• C. Abstinence from alcohol
• D. Beta-blocker therapy

Answer: (C)

Stopping alcohol is the most important first step because ongoing ethanol exposure continues to injure the myocardium. When the toxin is removed, the heart has a chance to recover some function, and symptoms often improve over weeks to months. After abstinence, treat the heart failure with guideline-directed therapies as needed (for example, ACE inhibitors, beta-blockers, and diuretics) to support recovery and prevent progression. High-sodium diets would worsen heart failure symptoms, and while medications like ACE inhibitors or beta-blockers are important, they work best once alcohol exposure has been stopped.