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Published on December 29, 2020

Beware of this holiday drinking danger

Holiday Alcohol

Eat, drink and be merry this holiday season, but go easy on the alcohol – for your heart’s sake.

Young and middle-aged adults often show up in the emergency room this time of year complaining of not feeling well, dizziness, shortness of breath, palpitations or chest pain.

The culprit can be a rapid fluttering of the heart’s upper chambers – called atrial fibrillation or AFib, for short – caused by drinking too much alcohol. AFib over time can lead to stroke or death from heart failure.

The problem is so noticeable from Thanksgiving through New Year’s Day that doctors have a name for it: Holiday Heart Syndrome.

The typical patient with this problem has no previous history of cardiac problems. A subset of patients with the syndrome chronically abuses alcohol, according to Hyannis cardiologist Peter Chiotellis, MD.

“We see it on holiday weekends, as people are binge drinking,” he said.

Federal dietary guidelines for alcohol recommend no more than one drink per day for women and two for men. Binge drinking is defined as consuming within about two hours four drinks for women and five for men. Heavy drinking is considered eight or more drinks per week for women and 15 or more drinks per week for men.

Alcohol is a factor in 35 percent of all new cases of AFib, but for patients under age 65, alcohol is a cause in 63 percent of new cases, said Dr. Chiotellis. In his experience, most patients with Holiday Heart Syndrome were men between ages 20 and 40 – not older patients often associated with cardiac problems.

“Most of my 70- to 80-year-old patients are not binge drinking,” he said.

What Alcohol Does

Alcohol disrupts the heart’s electrical system by interfering with the calcium, sodium and magnesium ion channels that regulate rhythm, Dr. Chiotellis said. In addition, “it ramps up the nervous system – the sympathetic nervous system that controls fight or flight.”

Alcohol can dramatically worsen sleep apnea – repeated episodes of blocked breathing during sleep, he added, and the resulting drop in blood oxygen can trigger AFib.

While alcohol is commonly associated with liver damage, it is also toxic to the heart, Dr. Chiotellis said. Chronic overconsumption of alcohol can cause cardiomyopathy, enlarged and thickened heart muscle. Furthermore, regular alcohol abuse can result in a rapid heartbeat for long periods, an extended episode of AFib that can weaken cardiac muscle.

“Their heart rate may be 130-140 beats a minute, their heart racing like they’re on a treadmill 24 hours a day,” he said.

The syndrome can be successfully treated with medication and avoiding alcohol, Dr. Chiotellis said.

“Some people have one incident, and it never happens again,” he said. “But usually people who have AFib once are more susceptible” to having AFib again, especially if they have a familial predisposition to heart problems.

Dr. Chiotellis cautioned against consuming too many energy drinks or mixing them with alcohol, as they are loaded with caffeine and the combination can overstimulate your heart. His advice also applies to rum and coke and similar cocktails.

Another holiday threat to your heart is overindulging in food, particularly salty foods, Dr. Chiotellis said. This can contribute to congestive heart failure, in which fluid builds up in the body and the heart doesn’t work efficiently.

“Moderation is the key,” he said for holiday food and drink. “Quality over quantity.”