Shopping. Traveling. Planning family gatherings. The stress of the holiday season can make you feel like you need to slip some spirits into your hot cocoa. And at celebrations, there’s often plenty of alcohol around.
An eggnog or holiday cocktail might take the edge off at first. But having a few drinks too many can leave your heart pounding or skipping a beat. That may be a sign of something serious—holiday heart syndrome.
“Most adults shouldn’t be afraid of having a cocktail or so. It’s the holidays,” says Melissa Tracy, MD, a cardiologist at Rush. “But overindulging is not good for anyone.”
Tracy has a few facts about holiday heart syndrome to keep in mind before you raise another glass this season.
What is holiday heart syndrome?
Late November to early January isn’t just when several holidays happen back to back. It’s also a time when daylight hours are shorter, which can contribute to seasonal depression.
The stress, emotions and frequent parties can lead to binge drinking, and that can take a toll on people’s hearts.
This happens often enough that physicians named the condition holiday heart syndrome.
Holiday heart syndrome is when binge drinking during the holiday season causes abnormal heartbeats, also called arrhythmias.
“When you ingest an excessive degree of alcohol, it can absolutely irritate the heart’s conduction system,” Tracy says.
The conduction system keeps your heart beating regularly and pumping blood throughout your body. If it’s disrupted, the effects can be short term or long term. But you should definitely take them seriously.
“Holiday heart syndrome is not a benign condition,” Tracy says. “A lot of alcohol affects the heart. It’s not typically related to having one spiked eggnog. It’s an excessive amount either over one day or binge drinking over the holidays or weekends.”
What are the symptoms?
There are a few types of arrhythmias that can come with holiday heart syndrome.
One is premature ventricular contractions, or PVCs. These are extra heartbeats from the heart’s lower chambers that happen earlier than usual.
They’re fairly common, even in people who don’t have holiday heart syndrome. “We all get PVCs, but we get them minimally,” Tracy says.
These abnormal rhythms usually aren’t harmful. But if they happen frequently or over a long period of time, they can lead to serious heart issues.
PVCs can cause feelings that your heart is doing the following:
Skipping a beat
Fluttering
Thumping hard, followed by a pause
“When I have a PVC, I feel like my heartbeat is catching in my neck,” Tracy says. “Then it can feel like there’s a pause and release.”
Other types of arrhythmias that can come with holiday heart syndrome are atrial tachycardia, atrial flutter and atrial fibrillation, or AFib.
These abnormal heartbeats are similar in that they are fast rhythms in the heart’s upper chambers. But the main difference is that atrial flutter and atrial tachycardia are more organized, while AFib is more chaotic.
All these atrial arrhythmias can cause your heart to feel like it’s:
Racing
Pounding
Causing discomfort or pain
“You might feel almost as if your heart is pounding out of your chest,” Tracy says. “You feel your heart going very fast. It’s uncomfortable.”
Any type of holiday heart syndrome arrhythmia can come with other symptoms, including:
Lightheadedness
Dizziness
Nausea
Shortness of breath
Fatigue
Fainting
Who is most at risk for holiday heart syndrome?
Drinking too much alcohol is dangerous for anyone. But some people have a higher risk of health problems from drinking, including arrhythmias.
The following can increase your risk for holiday heart syndrome:
Obesity
High blood pressure
Heart disease
Existing arrhythmias and previous AFib episodes
Diabetes
Advanced age
Use of blood thinners
Many of these also increase the risk of heart and vascular disease in general.
Excessive eating, like binge drinking, is common during the holiday season, which can add to obesity and increase holiday heart syndrome risks.
“There’s definitely a connection between obesity and an increased propensity to develop atrial fibrillation,” Tracy says. “And there’s been substantial data to support that if a patient loses at least 10% of their body weight, it actually helps reduce the recurrence of AFib.”
It’s important to watch what you eat and continue to get enough exercise, which can be difficult around the holidays. But you can also overdo it with exercise.
“There are studies that show a u-shaped curve with exercise and AFib,” Tracy says. “So patients who don’t exercise are at an increased risk. But those extreme exercisers are at increased risk of developing AFib too.”
Tracy advises moderate exercise for most adults. She suggests 30 minutes of cardio at least five days per week to reduce heart health risks. That’s a total of 150 minutes per week of exercise.
Some good options for moderate exercise include brisk walking, jogging, cycling, swimming and water aerobics. Traditional Chinese exercises, like Tai Chi, can also give you a good workout while focusing on your breathing.
How long does holiday heart syndrome last? When is it an emergency?
Holiday heart syndrome can have short-term effects that may not last long, especially with appropriate treatment. But it could also have long-term effects that need more care.
The amount of time that immediate symptoms last can vary. The abnormal heart rhythms may stop after a short period. But if they last more than an hour or are causing a lot of discomfort, it’s important to treat it as an emergency.
“If the chest pain, shortness of breath, lightheadedness, nausea and other symptoms aren’t going away or are making you feel uncomfortable, you need to seek attention for those things,” Tracy says.
It may be time to go to the emergency room or urgent care.
But if the symptoms come and go, and they don’t create too much discomfort, Tracy advises that you should make an appointment with your primary care physician or cardiologist.
In the long term, holiday heart syndrome can lead to further complications.
“There’s a quote in cardiology, ‘AFib begets AFib,'” Tracy says. “So if you binge drink and you have an AFib episode, then you may have a greater likelihood of having it again. And the more times you go into AFib, the more times your heart may stay in it longer and have more difficulty getting out of it completely.
AFib can be paroxysmal, which means it comes and goes. But over time, it can become persistent, which means it sticks around for longer. That’s more likely to happen after repeated binge drinking.
Another complication that can come from AFib or excessive PVCs can be a weakening of the heart muscle.
“Several different arrhythmias, if not treated to get the heart back into a normal rhythm or rate controlled, can cause the heart muscle to get weak and can become less forgiving and less able to recover,” Tracy says.
Over time, atrial flutter and AFib can also cause blood clots that can travel to the brain and cause a stroke.
What is the treatment?
The first treatment for holiday heart syndrome is to stop drinking alcohol.
“If there is excessive indulgence, the recommendation is going to absolutely be to eliminate alcohol,” Tracy says.
This is especially true if alcohol abuse is happening often or if you have any of the risks for holiday heart syndrome—or heart and vascular conditions in general.
For symptoms that are not causing too much discomfort or don’t last long, some self-care may be the next step.
“If the immediate symptoms of abnormal heart rhythm are coming and going, then first of all, hydrate,” Tracy says. “Make sure you’re drinking lots of water. Make sure that you’re getting rest. Make sure that you’re eating.”
If those steps reduce symptoms, you may just need to follow up with your primary care physician or cardiologist. But if the symptoms continue for more than an hour or cause a lot of discomfort, it may be time to go to the emergency room or urgent care.
One of the treatments for arrhythmias is rate-controlling medication, like a beta blocker or calcium channel blocker. These can quiet down extra heartbeats or slow down an abnormal heart rhythm.
“That may be all you need,” Tracy says. “But if arrhythmias have already had an impact on the function of the heart, then you could need an antiarrhythmic medication. Or you could require something called cardioversion, which is where we actually shock the heart back into a normal rhythm.”
Another treatment for long term arrhythmia issues is called an ablation. That’s a procedure where an electrophysiologist inserts a catheter through an artery or vein and into the heart. They then deliver energy through the catheter to disrupt the heart tissues that are causing the arrhythmias.
“That would be something you might need when you’ve exhausted your less invasive treatments or for certain patients whose doctors recommend they have an ablation sooner rather than later,” Tracy says.
Of course, it’s best to avoid holiday heart syndrome altogether by taking care of yourself this season.
“People use the holidays as excuses for being a bit absent from taking care of themselves,” Tracy says. “On the contrary, we should say, ‘You know what? The holidays are stressful. But I need to stay focused, and I want to give myself a gift—the gift of health.'”
If you care about heart health, please read studies about how eating eggs can help reduce heart disease risk, and Vitamin K2 could help reduce heart disease risk.
For more information about heart health, please see recent studies about how to remove plaques that cause heart attacks, and results showing a new way to prevent heart attacks, strokes.
Written by Mike Clark, Rush University Medical Center.
