Holiday heart syndrome: The warning signs to watch for - whatever your age

Medical professionals have warned about the cardiac risks the holiday season carries for decades. Illustration / Nadia Hafid, The New York Times

I’ve learned to love the chaotic haze that is December: my frantic attempts at wrapping presents and ticking off items on my to-do lists, squeezed between company parties and catch-up drinks before everyone disperses for the holidays. But that booze-filled blur also makes the holidays peak time for cardiovascular issues, doctors say: more people die from heart attacks between Christmas and New Year’s Day than any other period throughout the year.

“We drink and eat so much more and exercise and relax so much less than really any other time of year,” said Dr Nicholas Ruthmann, a cardiologist at the Cleveland Clinic.

Medical professionals have warned about the cardiac risks the holiday season carries for decades. In the 1970s, doctors gave a name to the particular toll of celebratory binge drinking: holiday heart syndrome. They had noticed otherwise healthy patients streaming into emergency rooms after drinking during holiday festivities with atrial fibrillation, or irregular heart rhythms.

“We see it in young people, old people, anybody,” said Dr Kristen Brown, a cardiovascular fellow at the University of Nebraska Medical Center who has researched holiday heart syndrome.

Holiday heart is really just another phrase for alcohol-induced atrial fibrillation, or A-fib, which is a rapid, chaotic heart rhythm. A-fib is one of the most common cardiac conditions, said Dr Gregory Marcus, a professor of medicine in the division of cardiology at the University of California, San Francisco, who has studied alcohol and A-fib.

Many people with A-fib won’t have any symptoms, said Dr Hugh Calkins, a professor of cardiology at Johns Hopkins Medicine. Those who do have symptoms might experience fluttering or pounding heart palpitations, chest pain or shortness of breath; some have extreme fatigue and even pass out. For some people, A-fib comes on in brief spells, but for others the condition can become permanent.

For some people, A-fib comes on in brief spells, but for others the condition can become permanent. Photo / 123RF

It’s especially important to watch out for symptoms because A-fib can increase the risk that you will have a stroke; it has also been linked to dementia and heart failure, Calkins added.

According to the Centers for Disease Control and Prevention, the death rate from A-fib has been rising for more than two decades, an increase doctors partly attribute to an aging population in the United States.

Your risk goes up with age; by the time you’re 80, you have about a 10 per cent chance of having the condition, Calkins said. He cited other risk factors as well: you’re more likely to have A-fib if you are tall (one study found that people taller than 5 feet 7 inches were at an increased risk), obese, or have a family history of early-onset A-fib.

Doctors typically diagnose A-fib through an electrocardiogram.

“A common scenario”, Calkins said, is that a patient turns 50, goes in for a colonoscopy to screen for cancer, ends up getting an electrocardiogram, “and lo and behold, they have A-fib”. But as smartwatches with heart monitors have become more popular, people are noticing changes in their heart rhythm on their own, he said, and seeking out cardiologists.

“Never in the history of our field have there been so many patients lining up to see us,” he said.

Doctors are still trying to understand exactly how alcohol affects the heart, Marcus said. One working theory is that alcohol induces alterations in your nervous system, which typically regulates heart rate. Excessive alcohol may also change the electrical signals within your heart, which coordinate the contraction of your cardiac cells.

Over the past 10 years, scientists have strengthened the link between alcohol and A-fib. One study showed that just a single drink a day can raise the risk of A-fib by 16 per cent. Even so, the increased chance may not be drastic for the average person.

“If on a given day, the chance of you having A-fib tomorrow is 1 in 1000 — if you have a glass of beer or wine tonight, maybe it’s 3 in 1000,” Calkins said.

But people of all ages should still be aware of the warning signs, he added.

People tend to ignore their symptoms over the holidays and wait until the new year to get medical attention, Ruthmann said. But it’s critical to seek out care if you have a persistent racing heartbeat and chest pain, or if you’re struggling to breathe. Dizziness and feeling lightheaded or confused can also indicate a cardiac issue.

“Every second counts when it comes to the heart,” Ruthmann said.

Limiting the amount of alcohol you consume may help protect the heart, but for those who choose to drink, here are a few ways to stay heart-healthy:

Hydrate. If you’re drinking over the holidays, make sure to have a full glass of water between each beverage, Ruthmann said. Dehydration increases the risk of holiday heart syndrome, Brown said, so it’s essential to make sure you stay hydrated.

Don’t skip medication. Many people leave their heart or blood pressure medications behind in the shuffle of travelling to see family and friends, thinking they can go a few days without them, Ruthmann said. But it’s important to keep taking medication as scheduled.

Find time for fitness. Moderate exercise may help buffer against A-fib. If you have a regular exercise routine that you can’t get to during the holidays, find some time for a modified workout — even if that’s just a walk around the block.

Manage stress. Stress can play a devastating role in increasing the risk of cardiac events, Ruthmann said. If you find yourself getting worked up, take a beat to breathe or try a grounding exercise.

As hectic as the holidays can get, make sure you’re listening to your body and paying attention to anything that feels off, he advised.

“A merry Christmas can turn into a scary Christmas fast.”

This article originally appeared in The New York Times.

Written by: Dani Blum

Illustration by: Nadia Hafid

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