Complications of excess alcohol intake in a man with heart disease
AI-generated summary
A 66-year-old man died from complications of excess alcohol intake in the setting of underlying heart disease. He had a 40+ year history of heavy daily alcohol consumption (12+ cans of beer plus whiskey daily), chronic pain from previous bowel surgery and hernia, and undiagnosed mild heart disease. Post-mortem toxicology showed ethanol 0.16 g/100mL and evidence of alcoholic ketoacidosis (elevated beta-hydroxybutyrate). He was on melatonin, indomethacin, mirtazapine and tramadol for pain, anxiety and depression. The coroner identified no specific clinical errors but used this case to highlight systemic gaps in Victoria's alcohol harm reduction strategy, noting a 20-year gap since the last coordinated action plan despite consistent evidence on what interventions reduce alcohol-related deaths.
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Specialties
general practiceemergency medicinepathologycardiology
undiagnosed mild heart disease with cardiomegaly and coronary artery disease
chronic pain from previous bowel surgery (Hartmann's procedure)
hernia causing ongoing pain
self-medication with alcohol for pain management
mental health issues including anxiety and depression
alcoholic ketoacidosis
lack of engagement with rehabilitation or counselling services
Coroner's recommendations
The Victorian Government, led by the Victorian Department of Health, should develop: (i) a new Alcohol Action Plan; or (ii) a program of work (including specific actions, timeframes, accountabilities, and public reporting on implementation and evaluation) to address alcohol-related harms in Victoria
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