Holiday heart syndrome is a clinical entity characterized by the development of cardiac arrhythmias associated with binge drinking and excessive alcohol consumption. The condition is transient and resolves spontaneously after abstinence from alcohol. The diagnosis can be made only after confirming a recent history of heavy alcohol drinking while physical examination and electrocardiography are used to diagnose cardiac arrhythmias.
Presentation
Holiday heart syndrome (HHS) was initially described in the late 1970s in individuals who consumed excessive amounts of alcohol during the holiday seasons and weekends (either on a regular basis or "binge" drinkers) and developed various forms of cardiac arrhythmias [1] [2] [3]. Scarce reports exist on the topic, but studies have determined that individuals who consume > 60 grams (or even > 36 grams) of pure ethanol/day are at a significant risk for atrial fibrillation (AF), the principal arrhythmia seen in patients with HHS [2] [4] [5]. The exact pathogenesis remains to be elucidated, but sudden intake of large amounts of alcohol seems to reduce the refractory period of the right atrium, impair vagal tone and promote conduction blocks [4]. When AF is present, patients can complain of dyspnea, palpitations, presyncope, weakness, light-headedness and fatigue [6]. In some individuals, an association between alcohol consumption and heart failure has been made, which is supported by the confirmed ability of alcohol to induce oxidative stress, electrolyte imbalance, scarring of the cardiac tissue and a negative inotropic effect by disrupting the activity of calcium channels [4] [5]. Heart failure, however, is more commonly related to chronic alcohol abuse, whereas HHS is an acute deterioration resulting from excessive amount of intake over a short period of time.
Entire Body System
- Pain
And, if your chest pain lingers beyond 20 minutes, it’s also wise to seek help, including possibly visiting an ER. “Listen to your body, and if something seems off, it probably is,” says Dr. Druz. [health.com]
Holiday Heart Syndrome: a cute term, sometimes an acute problem Background and definition: Most of us are aware that some medications that doctors prescribe can cause muscle pains. [healthcentral.com]
Heartburn, stomach upset, and feeling overstuffed are more typically signs of eating too much while squeezing chest pain or pain that radiates down one arm are classic signs of a heart attack. [bostonglobe.com]
If you feel chest pain, shortness of breath, pain or discomfort in one or both arms, neck or jaw or other heart attack symptoms, don't postpone treatment just because it's a holiday celebration. Call 911 for emergency care immediately. [franciscanhealth.org]
Chest pain that extends to the shoulder, arm, back or jaw is the classic sign of a heart attack, but others include abdominal pain, shortness of breath, sweating, dizziness, vomiting and fatigue. [denverpost.com]
- Falling
Kloner, MD, PhD, a professor at the Keck School of Medicine at the University of Southern California, on how to prevent falling victim to the holiday heart syndrome. [asiaone.com]
And you don't have to be older to fall victim to it. That can especially happen in young people, people who have no structure of heart disease, no previous heart attacks, no other medical problems The good news, it is an easily reversible problem. [local21news.com]
Label: Format: CD, Album Country: Released: Genre: Style: Tracklist Hide Credits 1 The Syndrome 0:40 2 Whatever You Say 3:11 3 Skulletor 3:27 4 Lion's Fall 3:40 5 Grandpa's Perfume 4:20 6 Alive 3:50 7 Hush 2:58 8 Another Fake 2:36 9 Courage 4:31 10 Let [discogs.com]
Electrical short circuit During atrial fibrillation, an electrical short circuit happens in the heart's upper chambers, causing it to fall out of synch with the two lower chambers. [scpr.org]
"So I stood up looking for a place to fall, and looking for my phone to call 911." Stewart underwent Double-Bypass surgery, and he continues to make positive strides for a healthy future. [wcyb.com]
- Asymptomatic
The patient stopped drinking alcohol and has remained completely asymptomatic. In this case, ventricular fibrillation was probably caused by the fibrillating atria combined with a fast AV node. [ncbi.nlm.nih.gov]
[…] shortness of breath Feeling confused, dizzy, faint or anxious “Some people who experience atrial fibrillation display symptoms of a rapid or irregular heartbeat – sometimes described as fluttering or ‘butterflies’ in the chest, while others are completely asymptomatic [blog.swedish.org]
Although it's often asymptomatic, it can lead to congestive heart failure or stroke. As the moniker suggests, holiday heart syndrome peaks on weekends and at holidays. [abcnews.go.com]
Cardiovascular status in asymptomatic alcoholics with reference to the level or ethanol consumption. Br Heart J. 1981;46(5):545-51. doi:10.1136/hrt.46.5.545 [ Links ] 25. Romero C. OH, el alcohol. Rev Urug Cardiol. 2007; 22(3):214-33. [ Links ] 26. [scielo.edu.uy]
Respiratoric
- Dyspnea
When AF is present, patients can complain of dyspnea, palpitations, presyncope, weakness, light-headedness and fatigue. [symptoma.com]
Symptoms of the condition include palpitation, shortness of breath or dyspnea, chest pain and swelling of the ankles and feet. [newsinfo.inquirer.net]
The patient may complain of dyspnea, palpitations, chest pain, dizziness, and near syncope or syncope and have signs of alcohol intoxication. [journals.lww.com]
People who have episodes of paroxysmal atrial fibrillation commonly experience symptoms of quite sudden onset, often including: Palpitations, in particular, noticing a rapid, irregular heart rate Dyspnea (shortness of breath), especially with any exertion [verywellhealth.com]
Common symptoms of heart failure are dyspnea, orthopedics, oedema and fatigue. However, other symptoms that are not mentioned above are reduced appetite and weight loss, confusion, depression, poor sleep, dizziness and concentration difficulties. [diva-portal.org]
Gastrointestinal
- Abdominal Pain
Chest pain that extends to the shoulder, arm, back or jaw is the classic sign of a heart attack, but others include abdominal pain, shortness of breath, sweating, dizziness, vomiting and fatigue. [denverpost.com]
Cardiovascular
- Heart Disease
Although many of the patients have underlying heart disease, there are reports of patients with no evident heart disease where acute alcohol injestion has caused arrhythmias. [ncbi.nlm.nih.gov]
#5 Holiday heart syndrome Holiday heart syndrome The term “holiday heart” is viewed with disfavor. Holiday heart syndrome consists of cardiac arrhythmias due to an acute ingestion of alcohol in patients without heart disease. [aapc.com]
Atrial fibrillation is a risk factor for a variety of heart conditions including stroke, heart attack, and heart disease. Celebrate Responsibly – Avoid the Risk of Overindulgence Holiday Heart Syndrome may have several triggers. [impella.com]
While having existing heart disease makes one more vulnerable to holiday heart syndrome, the sudden onset of atrial fibrillation mostly strikes perfectly healthy people with no existing heart issues. [detroit.cbslocal.com]
- Heart Failure
Alcohol is a cardio-toxin and heavy drinking can eventually damage the heart muscle leading to heart failure. Alcohol is a cardio-toxin and heavy drinking can eventually damage the heart muscle, leading to heart failure. [hippocraticpost.com]
Heart failure, however, is more commonly related to chronic alcohol abuse, whereas HHS is an acute deterioration resulting from excessive amount of intake over a short period of time. [symptoma.com]
However, Cho said alcohol and salty foods increase blood pressure, which can worsen the risk for heart failure in people who already have heart problems. She recommends planning ahead when attending a party. [news4jax.com]
“So, if they increase your blood pressure, some people end up having heart failure because it’s like a vicious cycle. So, it’s really important just to watch what you’re eating and doing.” For those who already have heart failure, Dr. [wxyz.com]
- Hypertension
“And certainly we know hypertension is one of the risk factors that can increase your risk for atrial fibrillation.” [detroit.cbslocal.com]
"And certainly we know hypertension is one of the risk factors that can increase your risk for atrial fibrillation." [edition.cnn.com]
So, if one is a known heart patient, or has some risk factors like being overweight, a heavy smoker, has hypertension, cholesterol problems and diabetes, one should take it easy during this season. [lifestyle.inquirer.net]
Nguyen adds that patients with hypertension should be mindful of salty foods. Along with sugary foods, which are characteristic of holiday fare, consuming these foods can raise blood pressure to dangerous levels. [sharp.com]
In people with the more typical forms of atrial fibrillation (that is, not associated with alcohol or celebrations), the arrhythmia may be caused by underlying heart disease, aging, hypertension, obesity, or a sedentary lifestyle. [verywellhealth.com]
- Thrombosis
Yes, that means more trips to the restroom, but that has benefits, too, in that it gets your legs moving and decreases your risk of blood clots in the legs due to deep vein thrombosis (also called “economy class syndrome”). [atrialfibrillationblog.com]
Antithrombotic therapy for atrial fibrillation: Antithrombotic Therapy and Prevention of Thrombosis, 9th ed: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines. Chest. 2012 Feb. 141 (2 suppl):e531S-75S. [emedicine.com]
Neurologic
- Stroke
“There may be people who present with a stroke to the emergency room and at that time doctors are dealing with the acute stroke,” Gulati said. [detroit.cbslocal.com]
"There may be people who present with a stroke to the emergency room and at that time doctors are dealing with the acute stroke," Gulati said. [edition.cnn.com]
It’s good if one survives a heart attack, stroke or life-threatening AF. Many are not fortunate and die before reaching the hospital. [lifestyle.inquirer.net]
According to the unofficial study, there were 153 cases of heart attack and stroke reported in December 2004; 163 during the same month the following year; 172 in 2006, 170 each in 2007 and 2008. [newsinfo.inquirer.net]
The probability of an ischemic stroke is extremely high in such patients, even if they do not experience any signs of AFib. [alcoholaddictiongethelp.com]
- Dizziness
The next, you may feel shortness of breath, chest pain, dizziness, or heart palpitations (a feeling that your heart is beating faster than usual), says Dr. Druz, adding that people can even feel lightheaded or pass out. [health.com]
Shortness of breath Pain or pressure in your chest Experiencing confusion, dizziness or feeling faint Sweating Feeling very fatigued and weak There are tests your doctor can do to check your heartbeat and the electrical impulses in your heart. [northshore.org]
Other symptoms of atrial fibrillation may include shortness of breath, fatigue, dizziness and chest pain. If you have these symptoms, call 911, Dr. Chandra advises. [premierhealth.com]
The arrhythmia observed in holiday heart-sufferers after excessive drinking and eating is called Paroxysmal Atrial Fibrillation (AF), characterized by rapid and irregular heartbeat, shortness of breath, anxiety, fatigue, dizziness, and sweating. [manilatimes.net]
Patients become lightheaded, dizzy and develop an abnormal heart rhythm such as atrial fibrillation after exposure to excessive amounts of alcohol. In most cases, it’s people who consume more alcohol than they usually do. [delawareonline.com]
- Burning Sensation
Symptoms of Holiday Heart Syndrome Racy heart and palpitations Dizziness Excessive sweating Burning sensation while urinating Blood in urine “If you sense any of the mentioned symptoms you must immediately seek medical help. [pharmeasy.in]
Workup
As HHS is a syndrome related to binge drinking during the holidays or weekends, a detailed patient history is essential to point towards the diagnosis. A recent history of consumption of large amounts of alcohol or attending some events or celebrations can provide an inital clue, while physical examination can confirm alcohol intoxication and arrhythmias. Alcohol in the patient's breath and irregular pulses may be often encountered [6]. A heterogeneous anamnesis from friends or family members is favorable if the patient is not competent to provide adequate data, or if patients deny alcohol consumption. If signs of cardiac conduction abnormalities are present, electrocardiography (ECG) should be performed promptly. Typical findings of Atrial Fibrillation(AF) on ECG are absence of P waves, irregular R-R intervals and QRS complexes with fibrillatory (f) waves appearing at rates as high as > 300/min) [6]. If AF is confirmed, cardiac ultrasonography is recommended, in order to assess the entire cardiac apparatus and determine whether additional abnormalities, such as scarring, atrial or ventricular dysfunction, and other signs of myocardial injury are present. Assessment of serum electrolyte levels (especially potassium levels) and thyroid hormone levels are recommended in the initial workup as well [6].
Treatment
The best way to overcome alcohol-related disorders is to seek advice from professionals and get the right treatment at the right time. [alcoholaddictiongethelp.com]
All content of this newsletter is intended for general information purposes only and is not intended or implied to be a substitute for professional medical advice, diagnosis or treatment. [flushinghospital.org]
Treatment options Because the arrhythmia may resolve within 24 hours on its own, antiarrhythmic therapy usually isn't indicated. [journals.lww.com]
This may be carried out in hospital if the above treatments don't work. [nhs.uk]
Prognosis
Some patients may develop end-stage liver disease which also has a poor prognosis. [ncbi.nlm.nih.gov]
Etiology
Keywords : Alcoholism [complications]; Arrhythmias, Cardiac [etiology]; Holidays; Atrial Fibrillation; Review. [scielo.br]
This chapter will discuss holiday heart syndrome in detail including etiology, epidemiology, pathophysiology, histopathology, history and physical, recommended tests, treatment, and potential complications. [ncbi.nlm.nih.gov]
Epidemiology
Larsson, Ph.D., Associate Professor, Unit of Nutritional Epidemiology, Institute of Environmental Medicine at the Karolinska Institutet in Stockholm, was lead author of the study. [drugabuse.com]
Epidemiology The frequency of Holiday heart syndrome is unclear due to conflicting evidence. [ncbi.nlm.nih.gov]
Pathophysiology
The pathophysiology of Holiday heart syndrome, or alcohol-induced arrhythmia, is complex, and therefore not completely understood. [ncbi.nlm.nih.gov]
Prevention
Preventing ‘holiday heart’ Tips for preventing holiday heart while still enjoying your holidays include being conscious of the amount of alcohol you are consuming during the event, and staying well hydrated. [detroit.cbslocal.com]
Preventing 'holiday heart' Tips for preventing holiday heart while still enjoying your holidays include being conscious of the amount of alcohol you are consuming during the event, and staying well hydrated. [edition.cnn.com]
Philippine Daily Inquirer, December 27, 2016. http://lifestyle.inquirer.net/248983/beware-holiday-heart-hazard/ Bunch, TJ, Preventing Holiday Heart Syndrome. [a-fib.com]
Also read: 7 Natural Cholesterol Reducers For A Healthy Heart How to prevent Holiday Heart Syndrome? A very simple way to prevent Holiday Heart Syndrome is to drink alcohol in complete moderation. [doctor.ndtv.com]
Patient Services Medical Center Physicians Group Claude Moore Library School of Nursing School of Medicine UVA A Blog About UVA and Your Healthcare People of UVA Prevention Kids Patient Stories General Health News Recipes Search for: Club Red has joined [clubreduva.com]
References
- Ettinger PO, Wu CF, De La Cruz C Jr, et al. Arrhythmias and the "Holiday Heart": alcohol-associated cardiac rhythm disorders. Am Heart J. 1978;95(5):555-562.
- Samokhvalov AV, Irving HM, Rehm J. Alcohol Consumption as a Risk Factor for Atrial Fibrillation: a Systematic Review and Meta-Analysis. Eur J Cardiovasc Prev Rehabil. 2010;17(6):706-712.
- Gronroos NN, Alonso A. Diet and Risk of Atrial Fibrillation: Epidemiologic and Clinical Evidence. Circ J. 2010;74(10):2029-2038.
- Liang Y, Mente A, Yusuf S, et al. Alcohol consumption and the risk of incident atrial fibrillation among people with cardiovascular disease. CMAJ. 2012;184(16):E857-866.
- Tonelo D, Providência R, Gonçalves L. Holiday Heart Syndrome Revisited after 34 Years. Arq Bras Cardiol. 2013;101(2):183-189.
- Porter RS, Kaplan JL. Merck Manual of Diagnosis and Therapy. 19th Edition. Merck Sharp & Dohme Corp. Whitehouse Station, N.J; 2011.