Holidays and Your Heart

By Gregory Katz, MD  |  12/22/2020

Every year around the holidays, there’s a spike in cardiovascular symptoms leading to more doctor’s visits, hospital admissions and new prescriptions.

This spike in cardiac issues around the holidays was first described in the 1970s and termed “Holiday Heart Syndrome” for obvious reasons. Additional research suggests you have a higher likelihood of dying from a heart attack during the holidays than during the rest of the year.

Each year around this time, a few media organizations will do a segment on holiday heart syndrome with a few pithy recommendations about how to prevent it.

The original articles looked at the heart’s electrical system, but the cardiovascular impact of the holidays isn’t just felt with abnormal heartbeats. Let’s take a look at the different manifestations in a bit more detail.

I break these down in my head to the acute manifestations (irregular heartbeats and heart attacks) and the chronic manifestations (weight gain and increased risk of chronic medical problems) of the holidays.

Irregular heartbeats

Atrial fibrillation (often called Afib) is the most common irregular heartbeat in America. Around 3 million Americans have this abnormal heart rhythm, which increases your risk of stroke and congestive heart failure.

The most common symptoms of Afib are palpitations and shortness of breath. But many people don’t have symptoms at all.

The increased incidence of Afib around the holidays seems to be related primarily to increased alcohol consumption. Alcohol has a number of different biologic effects on the heart, and it’s well described that a single episode of heavy drinking can cause someone to go into atrial fibrillation.

Identifying atrial fibrillation is best done with an electrocardiogram (also known as an EKG or ECG), but there are plenty of home monitors that can help pick it up.

The answer for how to prevent Afib around the holidays is obvious - don’t drink heavily. But it’s equally important to call your doctor immediately if you develop new symptoms of palpitations, shortness of breath or chest discomfort.

The question that naturally arises after this happens: does having a single episode of Afib around the holidays brought on by heavy drinking mean that you “have Afib?”

Every patient needs to be thought of individually and would depend on the conversation you have with your cardiologist and the results of any tests they may run.

Heart attacks

There’s certainly a signal that heart attacks are more likely around the holidays than other times of the year. Take a look at this graph from a British Medical Journal article on calendar timing of different types of heart attacks:

Now, anytime you see an increased incidence of anything medical, you need to ask yourself if there’s truly an underlying change in the disease or if what we’re seeing is just a matter of better detection.

Put more simply: Are more heart attacks diagnosed around the holidays because people are with family who make them go to the hospital when they would otherwise ignore their symptoms?

I don’t think that’s the case here, because if this phenomenon were just about better detection, you’d expect a drop-in incidence right after the holidays. That’s not what we’re seeing.

The death numbers bear this increased likelihood of a heart attack out: More people die from heart disease around the holidays than any other time of year, at least partly because more people are having heart attacks:

So, what explains more heart attacks around the holidays? A handful of different proposed mechanisms have been thrown around. A few potential culprits:

  • Emotional stress associated with the holidays
  • More physical activity in cold weather
  • Changes in diet and alcohol consumption
  • Delay in seeking medical care until after the holidays

Anytime you see a handful of different explanations for something, that probably means two things: 1) no one really knows; and 2) whatever you’re looking at is probably multifactorial, meaning there’s more than one contributing factor.

The bottom line: Heart attacks occur more frequently during the holidays, and people are more likely to die from heart disease during this time. That means you should be prompt in seeking out medical attention if you develop any symptoms of new chest pain, chest pressure, trouble breathing or generally feeling unwell.

The other big issue with the holidays: weight gain

It’s no secret many Americans are overweight.

But weight gain doesn’t just happen suddenly. It’s a gradual process taking place over years. And it seems the insidious weight gain around the holidays plays a really important role here.

According to some research, the average person gains about a pound over the holidays. And folks don’t seem to sustainably lose this weight afterward.

That may not seem like much, but if it happens every year between ages 20 and 40, all of a sudden you look back and you’ve gained 20 pounds.

I suspect this slow creep of gradual weight gain is important for many of us.

Now, I’m not going to lie to you and tell you gaining one pound is really that big a deal. But just like a journey of 1,000 miles begins with a single step, the march toward obesity begins with a single pound of weight gain.

I’m not going to offer you 10 tips for avoiding holiday weight gain. But information is power, and now you’re armed with the knowledge of common holiday weight gain. So, you can do something about it.

Happy holidays to all!

Dr. Gregory Katz is a cardiologist with The Heart Center, a division of Hudson Valley Cardiovascular Practice, P.C., now part of Nuvance Health. For more information on cardiovascular care and The Heart Center, visit www.nuvancehealth.org/heartcenter