Chronic consumption of ethanol has deleterious effects on the cardiovascular system, as manifested by an attenuation in myocardial contractility, a reduction in cardiac output, and the induction of arrhythmia. The arrhythmogenic effect of ethanol is associated with the high incidence of sudden death in alcoholics. Further, alcohol was found to potentiate arrhythmias due to nonpenetrating chest trauma, a finding of profound clinical significance. In addition, chronic ethanol consumption is closely linked to hypertension. Whether modest alcohol consumption may protect against coronary artery disease is controversial and not clearly established. Cessation of alcohol consumption occasionally results in reversal of ethanol-induced myocardial injury. However, the transition from ethanol-induced reversible injury to permanent heart damage is not well understood. Finally, the combined effects on the myocardium of alcohol and other abused drugs, such as cocaine and amphetamines, and the interaction of ethanol with chemicals such as nicotine, digitalis, and other medicaments are not well understood and may be fatal.