Features November 2010 Issue

Take Precautions for Your Heart This Holiday Season

Overindulging and taking other risks can put your heart in jeopardy this winter.

Itís a time of celebrations, with holiday toasts and feasts marking the gathering of families and the close of another year. Itís also a time when much of the world endures cold temperatures and snowy driveways.

Illustration by Marty Bee.

Too much alcohol consumption can send the heart into an episode of atrial fibrillation, in which electrical impulses in the atria (1) send chaotic signals through the AV node (2), which in turn triggers rapid ventricular impulses (3) that make the heart feel like itís racing. If palpitations last for more than five minutes seek medical attention.

And as cardiologists can attest, those factors mark a period when your heart health is at considerable risk.

For example, people with no known heart disease or structural heart disease who imbibe in alcohol to excess are at risk of whatís commonly called, "holiday heart syndrome." Cleveland Clinic cardiologist Curtis Rimmerman, MD, says a night of heavy drinking could be followed by an episode of atrial flutter or atrial fibrillation. "They feel a rapid heart beating that originates from the upper chambers of the heart," he explains.

How you respond to "holiday heart" depends on whether youíve experienced similar episodes previously. "If itís new onset and it lasts more than five minutes, you should get to a doctor," Dr. Rimmerman says. "It needs to be evaluated. If youíve experienced it before and you know that it dissipates, you may want to wait it out."

Heart patients who have had occasional moments of heart palpitations may even be instructed to take an extra beta blocker or other medication by their doctors. This is known as the "pill in the pocket" approach, Dr. Rimmerman explains. He adds that if a sudden onset of heart palpitations comes on and lasts more than five minutes, you should have someone drive you to the emergency room, rather than drive yourself, because you may be at risk of a heart attack or of passing out.

Alcohol is a vasodilator, which means it relaxes and widens blood vessels. However, that can trigger blood pressure to rise or lower considerably, Dr. Rimmerman says. Alcohol consumption can also lead to an unexpected release of catecholamines, which are "fight or flight" hormones that can put extra stress on the heart.

Watch what you eat

Alcohol consumption is not the only holiday-season threat to the heart. What you eat, and in particular, how much you eat, can also have serious consequences. A holiday ham or turkey or processed foods high in sodium can pose a serious threat.

"A sudden sodium load may unmask signs and symptoms of heart disease that werenít present before," Dr. Rimmerman says.

An excess of sodium in the bloodstream can raise blood pressure. And for patients with diastolic dysfunction (the heart wonít relax sufficiently to fill with blood before itís ready to pump blood to the body), sodium can negatively impact pulmonary circulation and lead to fluid or congestion in the lungs and a condition known as congestive heart failure. Patients with advanced coronary disease are also at risk of a serious cardiac event from sodium overload.

Get out of the cold

Exertion, such as shoveling snow, can put an additional unhealthy burden on the heart.

Extreme temperatures, both hot and cold, can take a toll on the heart. In high heat and humidity, sweating leads to a loss of fluids, which in turn means a lower volume of blood. The result is that the heart has to work harder to pump blood throughout the body.

Likewise, cold temperatures can cause arteries to constrict, Dr. Rimmerman says, and that can mean reduced blood flow to the heart as well as stress on the heart to pump blood through narrower vessels. Recent research also notes that as the temperature drops, the risk of heart attacks increases in the winter.

So it follows that exertion, such as shoveling snow, can put an additional unhealthy burden on the heart. "People who have advanced coronary disease should not be out doing those things," he adds. "A lot of this is just common sense."

Move your legs while traveling

If your holiday plans include a long trip, either by airplane or automobile, you should be aware of the risks associated with being seated for hours at a time. Sitting for long periods of time can raise your risk of a blood clot forming in your legs, but there are steps you can take to lower that risk.

"If youíre not on a daily aspirin, and your doctor says itís okay, start taking one five to seven days before you travel," Dr. Rimmerman advises. "When you are traveling, get up and walk around every hour or so. When youíre seated, pump your legs as youíve probably been instructed."

Leg exercises while traveling include foot lifts, in which you start with your feet flat on the floor and lift your toes for a few moments, before lowering them and raising your heels for a few seconds. You can also alternate lifting each knee for a brief hold. Curling your toes also helps keep blood flowing. And as much as possible, try extending your legs, but avoid crossing your legs for more than a few moments at a time.

Dr. Rimmerman adds that if youíve had a blood clot before, but you donít currently have one, talk with your doctor about your travel plans. You may be advised to take an additional anticoagulant or take other precautions.