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Holiday Heart Syndrome : To drink or not to drink alcohol during Xmas Season

December 16, 2023 Dr. Tony Leachon 1445 views

Dr. Tony LeachonHOLIDAY heart syndrome typically refers to atrial fibrillation induced by binge alcohol consumption, frequently observed during long weekends, vacations, and holidays. The most common symptom that patients present with is palpitations.

One of the factors that can affect your heart rhythm is the amount of alcohol you consume. Alcohol can trigger atrial fibrillation (AF or AFib), an irregular rhythm in the upper chambers of the heart, which can feel like fluttering or rapid pounding sensations in the chest.

WHAT IS HOLIDAY HEART SYNDROME?

Holiday heart syndrome (HHS) was first identified in 1978 by Dr. Philip Ettinger.

It is when healthy people without heart disease known to cause arrhythmia (irregular heart rhythm) experience an acute cardiac rhythm disturbance known as atrial fibrillation after excessive alcohol intake. Dr. Ettinger came up with the name since episodes of these cardiac arrhythmias – which can happen in regular and non-regular drinkers – typically occurred after weekends or holidays.

The cardiovascular effects of alcohol are well known. However, most research has focused on the beneficial effects (the “French paradox”) of moderate consumption or the harmful consequences, such as dilated cardiomyopathy, associated with heavy consumption over an extended period. An association between the ingestion of acute alcohol and onset of cardiac arrhythmias was first reported in the early 70’s.

In 1978, Philip Ettinger described “Holiday heart syndrome” (HHS) for the first time, as the occurrence, in healthy people without heart disease known to cause arrhythmia, of an acute cardiac rhythm disturbance, most frequently atrial fibrillation, after binge alcohol drinking. The name is derived from the fact that episodes were initially observed more frequently after weekends or public holidays. Since the original description of HHS, 34 years have passed and new research in this field has increased the volume of knowledge related to this syndrome.

What does holiday heart syndrome feel like?

Holiday heart syndrome symptoms are the same as those for AFib. You might notice:

A lack of energy. You might feel very tired. More so than usual during the holidays.

Discomfort in your chest. It may feel painful or like there’s pressure in your chest.

Dizziness. You could become light-headed or feel like you’re going to faint.

Heat palpitations . You’ll feel a fluttering, racing, or pounding in your chest.

Trouble breathing. You might notice it’s harder to breathe as you go about your daily routine. But it’s also possible when you’re resting.

WHAT IS THE CAUSE OF HOLIDAY HEART SYNDROME?

Now we know holiday heart syndrome is also the result of a combination of factors beyond just drinking alcohol, including:

Caffeine

Over-consumption of fatty meals filled with salt

Stress

We see these factors combine for celebrations that can accompany Thanksgiving, Christmas, and New Year’s Eve.

Alcohol Consumption

In a study published in 2013 by the U.S. National Library the authors noted “alcohol has a definite role in cardiac arrhythmia either by chronic abuse or by binge drinking.”

They further noted that for patients visiting the emergency room with palpitations or other symptoms associated with cardiac arrhythmia, a “high suspicion of HHS should occur” if the patient exhibits signs of being intoxicated or admits to a recent episode of binge drinking.

The authors concluded that after the diagnosis of cardiac arrhythmia without evident heart disease, the physician should “explain the syndrome to the patient and recommend alcohol abstinence in an effort to prevent new episodes of HHS.”

While people with a history of heart failure or other cardiac conditions are at greater risk for serious complications, those who are otherwise healthy usually see their arrhythmia stabilized after treatment in an emergency room with beta blockers and other medications to reduce their heart rate.

Caffeine

The temptation of holiday-themed coffee drinks or a late-night coffee chat with family may mean people are consuming more caffeine than they’re used to. Too much caffeine can make your heart race.

Caffeine can also cause dehydration, which can lead to arrhythmia.

A 2023 study found that caffeine and alcohol are often consumed together, and their combination can cause irregular heart rhythms. It’s common at the holidays to consume more of these substances, and to consume them together. Be aware that it could increase your risk for irregular heart rhythm.

Overeating and weight gain

Whether enjoying a fabulous feast with friends and family at home or at a restaurant and at parties, it’s important to make sure you don’t overeat.

Well holiday diners that moderation is the key. This is especially important for those suffering from diabetes , hypertension, high cholesterol , and coronary artery disease.

An unusually heavy meal such as one the holidays are known for, or at any time of the year, can put additional stress on the heart as your meal is digested, and overeating and over-drinking can increase your blood pressure and heart rate.

These meals tend to be associated with very high salt intake, which can lead to high blood pressure.

Also, some research suggests that enjoying just one huge meal, despite previous healthy eating habits, is a bad thing and can quadruple the ordinary risk of a heart attack during the two hours after eating.

How is holiday heart syndrome treated?

It depends on your overall health. If your health already isn’t the best or unstable, your doctor will likely do cardio version. This is when they use quick, low-energy shocks to reset your heart rhythm.

They’ll also suggest you stop drinking altogether. Even if you can’t stop completely, studies show drinking less than 80 milligrams of alcohol per day may lower your risk of holiday heart.

If your overall health is good, the doctor will treat your problem and suggest you stop drinking.

Can I avoid holiday heart syndrome?

Yes. You don’t have to sit in the corner with a glass of water while everyone else lives it up.

Eat and drink in moderation. If you’re going to a big party in the evening. Eat lighter at breakfast and lunch. Or eat a full, healthy meal just before the event so you’re less tempted to overdo it. Instead of cutting a huge slice of your uncle’s famous pound cake, opt for a smaller sliver. And sip on one cocktail the entire night instead of going back for a second or third.

Keep moving. It’s important to stay active before, during, and after the holidays. Stick to your regular workout routine to keep your heart healthy. If you keep yourself healthy during and around the holidays, you’ll be less likely to have long-term heart issues.

Try your best to stay calm. You might feel extra stress during the holiday season. This is normal, but don’t let it get out of control. Leave time to relax and do things you enjoy. This can help improve your cardiac condition

It’s the season to eat, drink, and be merry. But overdoing it around the holidays can cause a condition known as “holiday heart syndrome.” Learn what it is and how you can boost your odds of a heart-healthy holiday.

Don’t drink alcohol if you’re high risk to develop Holiday Heart Syndrome.

Enjoy the holidays safely.

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Anthony C. Leachon, M. D.

Independent Health Reform Advocate

Past President ,
Philippine College of Physicians

Department of Internal Medicine
Manila Doctors Hospital

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