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Spotlight On: Holiday Heart Syndrome

Posted October 01, 2016

During the holidays, the spirits flow freely, the treats are always within reach and the to-do lists are endless. Perhaps more than any other time of year, this is the season we tend to overdo and overindulge. For some, all of this excess can lead to more than just a headache and indigestion. It can result in a condition called Holiday Heart Syndrome.

What is “Holiday Heart Syndrome”?

Broken ornament

This is a term coined in the late 1970s to describe the presentation of an acute disturbance of a heart rhythm (most often arising from the upper heart chambers or atria) in a person who had consumed a large amount of alcohol, such as during a holiday party. This happens to people who are generally healthy with no predisposing factors for arrhythmias (abnormal heart rhythms). The heartbeat irregularity in this situation, called supraventricular arrhythmia (or above the ventricles), most often resolves once the alcohol is broken down and excreted by the person’s system. We now know that acute supraventricular arrhythmias (holiday heart) can occur in the setting of a high degree of stress, illness or dehydration.  

Is it a real condition or just a phenomenon of stressful holidays?

Holiday heart syndrome is a real syndrome in which the heart’s vulnerability to certain arrhythmias is increased. A number of studies have shown an association between excessive alcohol ingestion (binge drinking) and onset of a heart rhythm disturbance. The most frequently seen arrhythmia is atrial fibrillation, in which the atria (top chambers of the heart) quiver or fibrillate causing the heart to beat irregularly and often quite fast. A more regular arrhythmia, called atrial flutter, or premature beats (extra beats) coming from either the top or bottom chambers may be seen as well.

What causes holiday heart syndrome?

It is not clearly understood why people with an otherwise normal heart develop these acute heart rhythm disturbances in the setting of alcohol, stress or dehydration. Theories have been proposed, including an association with release of epinephrine or nor-epinephrine (stress hormones that increase heart rate), sensitivity to alcohol (which is a toxin), a rise in fatty acids in the blood, stress (perhaps due to elevated cortisol levels) or dehydration. Regardless of the cause, holiday heart syndrome usually resolves once the precipitating event abates.

What are the symptoms of holiday heart syndrome?

The symptoms of holiday heart are related to an irregular and often fast heart rate. These include palpitations (a feeling of pounding in the chest, racing or skipping heart beats), shortness of breath — especially with exertion, chest discomfort or dizziness and feeling faint. While holiday heart usually passes quickly and is not life-threatening, it is important that you do not ignore these symptoms. Remember that if you have underlying heart disease, chest pain and shortness of breath can also signal a heart attack and rapid medical attention is needed to determine the cause of your symptoms.

What should I do if I think I am suffering from an arrhythmia?

You should go to the emergency room. There, physicians may need to treat you with medications to slow your heart rate down. You may also receive fluids through an IV (a catheter placed into the vein) to re-hydrate you. You should bring a list of medications with you, and be prepared to give details of your past medical history to the doctors and nurses. Most often, if you have no other heart disease, the arrhythmia will resolve within 24 hours, and you will be allowed to go home after the rhythm is stable. If, however, the doctors are concerned that you may have undiagnosed heart disease or if you have known heart disease, they may admit you to the hospital for observation and further evaluation.