The ‘holiday heart syndrome’

Let’s make sure the season of joy does not turn into a season of mourning.

Dr. Anthony Leachon, who has received several awards for his sustained efforts at preventive health education, wrote for the December issues of Vital Signs newspaper and H&L (Health & Lifestyle) magazine an informative article on the increased incidence of heart attack and stroke during the holiday season.

He cited renowned heart specialists who call this phenomenon “Merry Christmas Coronary, Happy New Year Heart Attack.” Several researchers abroad noted modest increases in heart attack, stroke and deaths during the holiday season peaking on Christmas Day, with a second peak on New Year’s Eve. The foreign authors thought that this was already alarming. Wait till they hear about the increase in similar acute cardiovascular attacks here in our country.

A 2004-2008 survey of Metro Manila hospitals showed a tripling of emergencies and admissions during Christmastime. That is a 200-percent increase.

It makes an excellent reminder for doctors and other healthcare professionals to forewarn patients on the unseen but lurking danger which a multiplicity of factors during the season could trigger. And half of these cardiovascular attacks could end up in sudden cardiac death. These hapless patients probably don’t even know what hit them. They can die on the spot, or they succumb even before reaching the hospital.

A sad illustration about this risk is what was reported in a remote Sicilian town very recently, when three middle-aged brothers all had a heart attack on the same day, with two dying suddenly. The third one was fortunate to be in a hospital when his heart attack happened, and prompt intervention at the emergency room stabilized his condition.

This may be an extreme situation and is not likely to happen to the average family. One can argue also that the three brothers were likely genetically predisposed to develop cardiovascular events, but it still goes to show that the hypercelebration of the season and the simply overcharged atmosphere can trigger a heart attack, stroke and other cardiovascular events, particularly in high-risk patients.

It could save some lives if these patients are identified and adequately forewarned about the incipient danger that comes with the start of the usually hectic holiday celebration. Mentally, they could prepare themselves and have the discipline to say “no” when they have had enough partying, and the temperance likewise not to overindulge in the rich foods and drinks that come with the holiday celebrations.

Overindulgence has been blamed as a major culprit responsible for the increased cardiovascular risk during the holiday season. With sometimes simultaneous parties one feels compelled to attend in the same night, one easily loses track of the number of drinks, calories or fats one has already taken. Add to that the fatigue and the raised adrenaline brought about by the excitement reunions and get-togethers generate, and one can fall victim to an unhealthy mixture of all triggering factors that could simmer to a catastrophic stew.

Physicians can give cardiovascular patients, particularly those classified as high-risk, a most memorable Christmas gift by properly forewarning them of this real and perilous risk during the holidays.

Dr. Leachon also shared in his article some pointers from Robert A. Kloner, MD, PhD, a professor at the Keck School of Medicine at the University of Southern California, on how to prevent falling victim to the holiday heart syndrome. These include:

— Dress warmly when it’s cold.

— Avoid heart stressors, including too much physical exertion, anger and emotional stress.

— Avoid excess salt, fats and alcohol. Binge drinking has been shown to trigger atrial fibrillation, an abnormal heart rhythm, which increases the risk of stroke, heart attack and heart failure.

— Get a flu shot. Infection and fever cause extra stress on the heart.

— Avoid breathing smoke in crowded places. Courteously remind those who still smoke in public places or during parties that they should refrain from doing so as they also affect other people’s health.

— Avoid also places where they make fires for warmth or to celebrate. In the States, heart patients are advised to stay away from the fireplace. Here, one should avoid getting near bonfires, which may be part of celebrations done outside the house. Ultra-fine particles in the air from burnt materials can be bad for the heart.

If you feel chest pain or other symptoms, call for help immediately. Time is gold during a heart or brain attack. Every minute counts and can spell the difference between surviving and succumbing to the attack. It’s better to err on the safe side if one is not sure if one’s symptoms are due to a heart or brain attack, or not.

We wish you a joyful and healthful yuletide season.