How to beat the Holiday Heart Syndrome
The holiday season is upon us, and after a year of social distancing and quarantining, people are excited to take (a perhaps ill-advised) break to see their family and friends, and enjoy holiday parties…
But have you ever heard of Holiday Heart Syndrome?
It sounds like it could be a good thing, but unfortunately it is not. Coined by Philip Ettinger and his team at the New Jersey Medical School back in 1978, the term Holiday Heart Syndrome refers to the increase in the number of patients arriving at the ER with heart conditions linked to excessive alcohol consumption during the holiday season. What is worrisome is that this syndrome can show up in seemingly healthy individuals.
In a recent study published in The British Medical Journal, results show that Christmas Eve is the day of the year with the most hospitalizations due to heart conditions related to alcohol consumption.
The excessive consumption of alcohol in short periods of time can lead to an accelerated heart rhythm and stimulate the production of adrenaline and noradrenaline — hormones that can cause cardiac arrhythmia.
Heart palpitations and altered rhythm (e.g. extrasystoles) are common with excessive consumption of alcoholic beverages. Some more serious cardiac arrhythmias (e.g. atrial fibrillation), however, can occur even in individuals without previous conditions. More importantly, irregular heartbeats are associated with serious complications, including heart failure and stroke. These complications can be fatal if not treated adequately. If the arrhythmia lasts for hours, it may be accompanied by:
- dizziness
- difficulty breathing
- chest pain
- loss of consciousness
Remember that in those cases immediate medical attention is required.
A syndrome of the young too
Younger people should be careful too. When alcoholic beverages are consumed together with energy drinks, which is common during festivities, the risk of arrhythmia increases. Energy drinks generally contain high amounts of caffeine and taurine. These substances lead to the irritation of the heart muscle, the myocardium. The high concentration of caffeine in some energy drinks is equal to or greater than many cups of coffee. Furthermore, the consumption of energy drinks often allows people to tolerate larger-than-normal amount of alcohol. Young people may have silent, asymptomatic, and undiagnosed heart conditions that, in most cases, only manifests itself when the heart is stimulated. These can quickly evolve into cardiac arrest and even death.
It’s not about habit…
The Holiday Heart Syndrome can also affect habitual drinkers. In fact, for individuals who routinely drink alcoholic beverages in large quantities, the damage may be even greater. Consuming alcohol quickly may favour the appearance or worsening of risk factors for the heart, or the development of diseases in the cardiovascular system. These are diseases such as
- arterial hypertension
- chronic cardiac arrhythmias
- cerebral vascular accident (CVA)
- myocardial infarction
- alcoholic cardiomyopathy
In addition to cardiovascular events, there is also the risk of:
- mental disorders
- various types of cancer
- liver problems (such as cirrhosis and alcoholic hepatitis)
- decreased immunity
- and even episodes of physical violence
Finally, with the use of alcoholic beverages in excess, there is a greater risk of sudden cardiac death, with or without previous cardiac events.
Ok, but isn’t some modest alcohol consumption beneficial? Several studies have brought forward this idea. However, the problem is determining the amount of alcohol that can reduce the risk of atrial fibrillation. We only have a clear range of consumption that reduces risk of cardiovascular disease in general.
The holiday season is a time to enjoy yourself, but this year has been hard as it is, you don’t need to help make it any worse. During your celebrations, it is important to follow a few suggestions to make them better and safer:
- Pace yourself — it is not a race
- Drink non-alcoholic beverages too — preferably water
- Consume alcohol with meals/food — not on an empty stomach
- Pay attention to symptoms — yours and from others around you
References:
- Ettinger PO. Holiday heart arrhythmias. Int J Cardiol. 1984;5(4):540–2.
- Ettinger PO, Wu CF, De La Cruz CJr, Weisse AB, Ahmed SS, Regan TJ. Arrhythmias and the “Holiday Heart”: alcohol-associated cardiac rhythm disorders. Am Heart J. 1978;95(5):555–62.
- Koskinen P, Kupari M, Leinonen H, Luomanmäki K. Alcohol and new onset atrial fibrillation: a case-control study of a current series. Br Heart J.1987;57(5):468–73.
- Engel TR, Luck JC. Effect of whiskey on atrial vulnerability and “holiday heart”. J Am Coll Cardiol.1983;1(3):816–8.
- Krishnamoorthy S, Lip GY, Lane DA. Alcohol and illicit drug use as precipitants of atrial fibrillation in young adults: a case series and literature review. Am J Med. 2009;122(9):851–6.e3.
- Kodama S, Saito K, Tanaka S, Horikawa C, Saito A, Heianza Y, et al. Alcohol consumption and risk of atrial fibrillation: a meta-analysis. J Am CollCardiol.2011;57(4):427–36.
