Christmas parties, families reunited and a little down time are all bound to invite extra imbibing.
And that makes for some busy emergency departments.
A frightening but usually harmless phenomenon known as “holiday heart” is seen year-round but tends to increase this time of year as more people have too many drinks. Holiday heart is a rhythm disturbance, usually atrial fibrillation, that can be seen in otherwise healthy people and is most common after heavy drinking. During atrial fibrillation, electrical signals are generated chaotically throughout the upper chambers of the heart. To patients, it can feel like their heart is racing and won’t stop for hours, sometimes days.
There’s no precise scientific answer to why this happens, but a link between alcohol and rhythm disturbances has been well-documented in medical literature. Dehydration and fatigue also can contribute, said Dr. David Bicknell, an electrophysiologist and heart-failure specialist with OhioHealth Heart and Vascular.
During an episode, the heart can beat at 150 to 200 beats a minute, he said. Normal adult resting heart rates run from 60 to 100 beats per minute.
The good news is that almost everyone who suffers an episode and has an otherwise healthy heart (and is not an alcoholic) will be just fine.
True holiday heart is usually seen in younger patients. Regardless of a person’s age and recent drinking history, an episode should be followed by a thorough exam that includes tests to make sure there is no undiagnosed heart problem, experts say.
“In my world, I see it fairly frequently, and quite honestly, it’s not just the holiday season that you see it,” said Dr. Frank Tice, a cardiologist with the Mount Carmel Health System.
It’s often seen on Fridays and Saturdays, “after people have a big night, after an OSU football game,” said Dr. Emile Daoud, section director of electrophysiology at Ohio State University’s Wexner Medical Center.
But the increase in prolonged cocktail hours during the holidays does tend to lead to a spike in cases; thus the name.
There’s no strong data on the phenomenon, but Tice estimated that 10 percent to 20 percent of patients younger than 55 who come to the hospital with a first episode of atrial fibrillation have holiday heart.
Although there aren’t good studies to back it up, some doctors say that caffeine, stress and poor eating habits could contribute.
Tice said patients often come in when they start to sober up and realize that their heart is racing. “They’re like, ‘Wow, something’s not right here.'”
Most patients’ hearts return to normal within 24 hours. In extreme cases, doctors have to shock the heart back into normal rhythm. Patients typically get fluids and a medication that slows the heart rate, Tice said.
Daoud said not every episode comes after an especially hard night of drinking. Some people get holiday heart after just a couple of drinks, but that’s less common.
Along with checking for more-serious heart problems, doctors who see patients with alcohol-related arrhythmia also should test for thyroid disease and assess whether the patient could be an alcoholic, he said.
For those who have a generally healthy relationship with alcohol, “I’m not telling people they can’t drink at all. It’s just that moderation is certainly the way to go,” Tice said.