Q&A: Acute alcohol consumption may lead to holiday heart syndrome

Even people without a history of heart disease could be vulnerable to atrial fibrillation when drinking more during the holidays, according to experts.

The term “holiday heart syndrome” describes the phenomena of when acute alcohol consumption leads to atrial fibrillation in a structurally normal heart — for example, when someone who does not typically consume alcohol binge drinks at a holiday party.

Randolph P. Martin, MD, FACC, FASE, FESC, the chief medical officer of Caption Health and emeritus professor of cardiology at Emory School of Medicine, spoke with Healio about holiday heart syndrome, how primary care providers can help inform their patients about it and more.

Healio: What is holiday heart syndrome?

Martin: Holiday heart syndrome is a very common cardiac disorder that we see during the holidays. It’s an acute, irregular, often rapid, heart rhythm disturbance — called “atrial fibrillation” — associated with excessive alcohol intake.

Healio: What are the symptoms?

Martin: Sudden onset of a racing heart, palpitations, dizziness, difficulty catching your breath — but usually not chest pain. It usually comes on 3 to 4 hours (potentially up to 9 hours) after excessive drinking and is often seen in younger people in their 30s and 40s without underlying heart issues.

Healio: How much alcohol use can lead to holiday heart syndrome?

Martin: Generally, five or more alcoholic drinks within a short period of time (but each individual is different). Excessive salt intake can also exacerbate symptoms.

Healio: If patients present with symptoms in a primary care setting, what should providers do?

Martin: Many people will end up going to the emergency room or urgent care because symptoms are so sudden and disconcerting, and often present later at night after drinking during the day/evening. In any case, if someone’s heart is beating fast enough and irregularly enough and they’re really feeling ill, they should seek medical attention and tell their provider they have consumed an excess of alcohol. This will usually lead to a full workup including an EKG, possibly some imaging.

Healio: What should providers say to patients who are asking about it?

Martin: The important thing to know is that this is reversible and treatable with medication. What I would tell patients: enjoy the holidays. But that doesn’t need to mean excessive alcohol consumption. If you’re going out to a party, drink water beforehand and throughout the event, space out your drinks, drink in moderation and avoid a high-salt diet.

Healio: Is there anything else you’d like to add?

Martin: The holiday period is stressful. Try to get rest and keep your life as “normal” or routine as possible. Besides holiday heart syndrome there is a about 5% increase in heart attacks during this time related to stress, not eating a balanced diet and not exercising regularly. If someone starts experiencing chest pain with exertion (possibly radiating out to the neck or arm), or feels unusually short of breath, then I would recommend talking to your doctor.