Patients with heart disease should avoid drinking alcohol, especially those with severe conditions such as heart failure and arrhythmias. Drinking can excite the sympathetic nervous system, increasing heart rate and triggering episodes of arrhythmia, and exacerbating heart failure. Heart disease patients typically require medication, and consuming alcohol during treatment can cause chemical changes in some medications, affecting their effectiveness. Both alcohol and medications need to be detoxified in the liver, so drinking while on medication can increase the liver's burden, potentially leading to long-term liver damage.