An emergency medicine specialist and cardiologist explain how the holidays can pose health risks and how to make them more “heart-friendly.”
Editor’s note: This article has been updated from an earlier version posted in November 2021.
While the holidays themselves can’t cause a heart attack, certain behaviors – and the hectic, festive season as a whole – may tax our heart health a lot more than we realize.
For years, studies have shown that heart attacks and other cardiac episodes, such as “holiday heart syndrome” and congestive heart failure flare-ups, surge during the winter holidays, starting at Thanksgiving. Cardiac-related deaths are almost five percent higher this time of year, according to the American Heart Association.
We spoke with emergency medicine specialist Dr. Henry R. Schuitema, and cardiologist Dr. Daniel Tarditi, who frequently see these repercussions – about how to keep the holidays as “heart-friendly” as possible and avoid unnecessary trips to the emergency room.
When Your Heart Health ‘Falls by the Wayside’
Preparing for the holidays demands a lot of time and effort in addition to our normal routine. Many people are fatigued before the party even begins, says Dr. Schuitema. “Because so much needs to get done, it’s easy to lose sight of self-care and turn to unhealthy behaviors that can make us vulnerable. Common triggers of cardiac complications include stress and overexertion; indulging in rich, salty foods; consuming too much alcohol; and delaying medical care.”
Stress and Your Heart
Stress is a common modifiable risk factor for heart attacks, notes Dr. Tarditi. Chronic stress can lead to high blood pressure and a rapid heart rate. As your heart works a lot harder than necessary, it can weaken the heart muscle over time.
When the pandemic started, rates of anxiety, depression, and other emotional implications started to spike, says Dr. Tarditi. “Over the past couple of years, cardiologists have seen more and more people present with palpitations and other symptoms that are due to fears and stressors stemming from COVID-19. When you add the holidays on top of this, it amounts to the perfect storm.”
Diet and Congestive Heart Failure
The typical “American diet” is substantially rich in salt, which does not bode well for people with existing cardiac disease, notes Dr. Schuitema. And while it may be a habit to break out your “Thanksgiving sweatpants,” adds Dr. Tarditi, cardiovascular disease doesn’t take a holiday. It’s important to be mindful of excess salt intake when you have a compromised heart, as high salt intake can trigger heart failure.
As fluid starts to build, you may notice sudden shortness of breath – which worsens when you lay down and improves when sitting upright – as well as swelling in the legs, arms or feet, explains Dr. Tarditi. If you or an older family member have congestive heart failure, remember to manage it well by taking all your medications as prescribed; double-checking with your provider on any restrictions if you plan to consume alcohol; and keeping a close eye on weight gain. Gaining more than two pounds a day or five pounds a week may indicate fluid retention or overload and should be addressed with your cardiologist.
Alcohol and ‘Holiday Heart Syndrome’
Holiday heart syndrome refers to bouts of supraventricular tachycardia – a sudden arrhythmia or irregularity in which the heart beats much faster than normal – due to stress, dehydration, and/or higher than usual alcohol intake, explains Dr. Schuitema.
Alcohol acts as a natural irritant to the heart muscle, adds Dr. Tarditi. Studies show that just one drink a day, over a 14-year period, can increase the risk for atrial fibrillation by nearly 1% . Heavier drinking may increase the risk for scarring, electrical abnormalities, heart attack and stroke.
“Holiday heart syndrome can affect anyone, even those who are otherwise healthy,” says Dr. Schuitema. You may feel pounding in your chest, shortness of breath or chest discomfort – all of which should be addressed in the emergency room to rule out something more serious, like a heart attack. Often, holiday heart syndrome will go away on its own, but some people will require medical treatment.
Why You Shouldn’t Ignore Symptoms
While it may seem more convenient to ignore symptoms and address them later, not doing so can keep us from preventing potentially fatal episodes, says Dr. Schuitema. Whether you’re traveling from out of state, not wanting to miss meaningful family time, or simply being afraid to mention that something feels wrong, catching something in its tracks is always better than delaying care.
Some tell-tale symptoms to watch out for, mentions Dr. Tarditi, include chest discomfort that worsens with physical activity; a sudden rapid heart rate accompanied with jaw pain, shoulder pain, or shortness of breath; fatigue and weakness; and swelling of the legs, ankles and feet.
‘Heart-Friendly’ Tips to Redefine Your Holidays
The holidays don’t have to be about overindulging until you feel sick (or become sick), continues Dr. Tarditi. Instead, you can focus on enjoying the well-spent time with your family, while ensuring you can be around for them for many years to come.
Drs. Tarditi and Schuitema recommend the following:
- Stay on track with medications. Try not to skip/miss doses. Whether you’re traveling or simply busy at home, you can set reminders to help.
- Remember – everything is okay in moderation. It’s okay to have treats – foods and drinks that you aren’t used to eating daily. You should savor them. However, you shouldn’t overdo it. Even the seemingly “healthiest” people can suffer; when your heart is compromised, the outcomes can be even worse.
- Take a break. This time of year, there’s one holiday and activity after another. It’s a fast-track. You have to come down from the stress. You can’t indulge all month. Take some time for yourself and pay attention to your health. Fall back into your routine habits, as much as possible, during the “in-between.”
- Let your family know about your condition. If you had a severe food allergy or intolerance, you’d let your family know about it before a meal, right? If you can’t have high-sodium dishes, perhaps they can adjust recipes to make them safer for you. You can also bring your own dishes.
- Listen to your body and address symptoms as soon as possible. Everyone has different limits based on their condition; your body will let you know when it’s not functioning well. When something feels “off,” don’t dismiss it. Reaching out to your provider over the phone or via telehealth right away may help prevent a trip to the ER during the holiday season.
[Main photo credit: FG Trade/E+]