Final answer:
A heart attack is especially fatal in the case of alcoholic cardiomyopathy due to the underlying weakened state of the heart muscle, increasing susceptibility to life-threatening complications like arrhythmias and heart failure.
Step-by-step explanation:
When a person suffers a heart attack due to alcoholic cardiomyopathy, the fatality risk escalates primarily because the heart muscle has been weakened by the toxic effects of alcohol. Alcoholic cardiomyopathy involves damage to the myocardium, resulting in a reduced capacity of the heart to pump blood effectively. This condition predisposes the patient to additional complications during a myocardial infarction such as arrhythmias, heart failure, and cardiac arrest. The bloodstream's inability to reach heart muscle tissue due to a blockage of the coronary artery leads to the death of cardiac muscle fibers, which cannot regenerate. Consequently, the damaged heart is less likely to withstand the stress of an MI, making survival less probable.