Holiday Heart Syndrome

Contributing author: Alice Krueger

In her made-for-TV movie, LeAnn Rimes advises everyone to “Put a little holiday in your heart..” That’s great, unless you end up in the Emergency Room with atrial fibrillation or a heart attack. Then you might be diagnosed with Holiday Heart Syndrome¹.

Atrial fibrillation feels like heart palpitations, caused by an extremely rapid abnormal heart rhythm in the atria or upper chambers of the heart. It is often accompanied by chest pain, shortness of breath and feeling light-headed, and may lead to stroke or heart failure.

A heart attack occurs when blood vessels in the heart muscle become blocked. The blockage is often a plaque of fatty substances (cholesterol) inside the hollow of the blood vessels. The affected area of muscle is damaged or dies from lack of oxygen, and the pumping action of the heart is impaired or stops altogether.

Heart injuries and heart attacks are most common during the holiday season. December 25 is the date with the highest rate of fatal heart attacks, followed by December 26 and January 1². The increase in deadly cardiac events on these dates might be due to several factors, including delaying treatment for cardiac symptoms “because it’s the holidays,” being sad or depressed, or abnormal amounts of exercise in cold weather (such as shoveling heavy snow).

Research has shown that one of the main causes of Holiday Heart Syndrome is heavy alcohol consumption³. While low alcohol consumption may have a positive effect on your heart’s health⁴, heavy drinking has devastating effects on the level of fatty acids in the blood and the functioning of the heart’s electrical pacing system⁵.

Heavy alcohol consumption is defined as more than 14 drinks in a week or more than 4 drinks in one day for men. For women, it’s defined as more than 7 drinks in a week or more than 3 drinks in one day⁶. One drink is defined as 12 ounces of beer, 5 ounce of wine, or 1.5 ounces of distilled spirits⁷ (reference 7 has a nice illustration of amounts). This means both steady higher levels of consumption and binge drinking are problematic, behaviors which may be more prevalent during the holiday season.

Other holiday lifestyle factors can result in cardiac problems. Overeating, probably even more common than usual during the holidays, causes the stomach and intestines to stretch out. This activates nerves that usually slow down the heart. However, in people who have atrial fibrillation, stimulation of these nerves may set off the irregular rapid heartbeat.

We also tend to take in excessive amounts of salt in our food. This causes our bodies to retain fluid, which raises blood pressure. If people already have high blood pressure or heart valve or heart failure issues, the increase in blood pressure may stretch out the atria of the heart and initiate atrial fibrillation.

The best way to prevent Holiday Heart Syndrome is to avoid heart injury factors that are within your control. Don’t drink alcohol, eat or consume salt in excess. Avoid stress and excessive physical exertion. And remember that reaching out to someone who is alone during the holidays not only will improve their heart health, it will benefit you as well.

Please have a happy and healthy holiday, everyone.

References

¹ Tonelo, D., Providencia R. & Goncalves, L. (2013). Holiday Heart Syndrome revisited after 34 years. Arquivos Brasileirios de Cardiologia, 101(2), 183-189.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3998158/

² Phillips, D.P., Jarvinen, J.R., Abramson, I.S. & Phillips, R.R. (2004). Cardiac mortality is higher around Christmas and New Year’s than at any other time: The holidays as a risk factor for death. Circulation, 110(25), 3781-3788.

³ Ettinger, P.O., Wu, C.F., De La Cruz, C., Jr., Weisse A,B,, Ahmed, S.S. & Regan T.J. (1978). Arrhythmias and the “Holiday Heart”: Alcohol-associated cardiac rhythm disorders. American Heart Journal, 95(5), 555-562.

⁴ Friedman, L.A. & Kimball, A.W. (1986). Coronary heart disease mortality and alcohol consumption in Framingham. American Journal of Epidemiology, 124(3), 481-489.

⁵ Laposata, E.A. & Lange, L.G. (1986). Presence of nonoxidative ethanol metabolism in human organs commonly damaged by ethanol abuse. Science, 231(4737), 497-499.

⁶ National Institute on Alcohol Abuse and Alcoholism. (2016). Drinking levels defined.
https://www.niaaa.nih.gov/alcohol-health/overview-alcohol-consumption/moderate-binge-drinking

⁷ National Institute on Alcohol Abuse and Alcoholism. (2016). What is a standard drink?
https://www.niaaa.nih.gov/alcohol-health/overview-alcohol-consumption/what-standard-drink

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