Spoilsport Of Holidays: “HOLIDAY HEART SYNDROME”.
Ho…. Ho…Ho…Holidays season round the corner. It is time to relax, party & enjoy forgetting all work pressures for some time. Parties are incomplete without friends, good food, dancing and good measure of Alcohol.While partying, you suddenly notice your well-built hunk friend suddenly complains of palpitations, chest discomfort giddiness & is about to pass out. As far as you know, he was regular at Gym with no medical issues & takes alcohol only at parties. What might have gone wrong, you wonder.
My friend, your friend has “HOLIDAY HEART SYNDROME.”
What is Holiday Heart Syndrome (HHS)?The HHS is defined as Alcohol induced Atrial Arrhythmia, is characterized by an acute cardiac rhythm &/or conduction disturbances associated with other heavy Alcohol consumption in persons without other evidence of heart diseases.In simple terms, following binge drinking of Alcohol, the Atria (upper Chambers of Heart) start beating rapidly at rate 200-250 beats / minute, and Ventricles (lower chambers of heart) also beat rapidly at rate of 150+ / minute. As a result, heart will be underfilled & will not be able to pump adequately in keeping with need of the body. Described by Philip Ettinger in 1975, this occurs in persons who binge drink (> 5-6 drinks in a row on one occasion in rapid succession).Though Atrial fibrillation most common arrhythmia in HHD other arrhythmias such as Atrial tachycardia, atrial flutter or ventricular premature beats may occur too. Though classicaly described as a problem occurring in patients with no previous history of heart diseases, it may occur in patients with preexisting heart conditions which can lead to deleterious complications.
Why Does HHS occur after ingestion of Alcohol?1. Ingested Alcohol makes heart muscle excitable with shortening Refractory Period ( period of heart beat when muscle will not respond to stimulus).2. Alcohol increases Catecholamines levels (stress hormones) which provokes the heart to beat faster & irregularly.3. Increase level of Free Fatty acids in blood stimulating Sympathetic Nervous System, which in turn stimulates heart muscle.4. Ingestion of large quantities of alcohol increases “Acetaldehyde”- a metabolite of alcohol which has deleterious effect on heart rate.
Symptoms of HHD:
Palpitations i.e., sudden pounding or fluttering of the heart.
Excessive undue fatigue with lack of energy.
Giddiness / light headedness.
Shortness of breath.
Chest pain or discomfort.
What to Do?
Holiday heart syndrome usually goes away within a few hours after recovering from an episode of heavy alcohol intake. And most cases resolve within 24 hours without any treatment. In some instances, Atrial Fibrillation may persist or come back on its own later.
But it is advisable to get medical help as soon as HHD is suspected as sometimes, though rare it may be fatal or can have other complications.
Doctor will get an ECG to see the rhythm of the heart. Some blood investigations & Echocardiogram may be ordered to rule out preexisting heart diseases.
Depending upon the severity of symptoms, ventricular rate & hemodynamic status of patient Doctor may decide to DC cardiovert, give rate &/or rhythm controlling medicines through IV or may decide to wait spontaneous recovery.
How to prevent HHD?
Moderation of Alcohol consumption is key factor in preventing HHD.
Avoid excessive exertion during drinks.
Hydrate yourself well.
Avoid or minimize consumption of high salty foods, Caffeine & sugars.
Conclusion: HHD is condition of abnormal heart rhythm following binge alcohol drinking especially during holidays. It can occur in healthy persons without previous history of heart diseases. Though it may resolve on its own, it may lead to cardiac complications. Prevention, early recognition & prompt treatment are key to have good outcome.
Be responsible…. drink moderately… Have a relaxing holiday…. Cheers.
