A 45-year-old with chronic heavy alcohol use presents with exertional dyspnea and palpitations. Echocardiography shows reduced left ventricular ejection fraction (LVEF 30%) and ECG demonstrates frequent ventricular ectopy. What long-term functional consequences should be anticipated if alcohol use continues?

• A. Exclusive progression to hypertrophic cardiomyopathy caused by chronic alcohol exposure leading to decreased chamber size rather than systolic dysfunction or arrhythmias.
• B. Spontaneous recovery of ejection fraction to normal values without any intervention because alcohol-related cardiac dysfunction is always transient and resolves despite ongoing exposure.
• C. Progressive systolic heart failure with worsening exercise intolerance and heightened risk of life-threatening arrhythmias and sudden cardiac death unless alcohol cessation and medical therapy are initiated.
• D. Development of isolated right-sided heart failure only, with preserved left ventricular function and negligible risk of arrhythmia-mediated complications in the long term.

Answer: (C)