THE winter season is a time for holiday toasts and feasts, marking the gathering of families and the close of another year, as well as a time when the world endures cold temperatures and snowy driveways...factors which cardiologists can attest mark a period when one’s heart is at considerable risk, says the November 2010 issue of the Cleveland Clinic’s Heart Advisor.

Cleveland Clinic cardiologist Curtis Rimmerman, M.D. says that individuals with no known heart disease who imbibe in alcohol to excess are at risk of what’s commonly called “holiday heart syndrome” which is an episode of atrial flutter or atrial fibrillation...“they feel a rapid heart beating that originates from the upper chambers of the heart”...following a night of heavy drinking.

How you respond to “holiday heart” depends on whether you have experienced similar episodes previously or not. “If it’s new onset and it lasts more than five minutes, you should get to a doctor,” says Dr. Rimmerman. “It needs to be evaluated. If you’ve experienced it before and you know that it dissipates, you may want to wait it out.”

Heart patients who have experienced occasional heart palpitations in the past may even be instructed to take an extra beta blocker or other medications by their doctors, and this is known as the “pill in the pocket” approach, explains Dr. Rimmerman.

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.

The heart letter offers a list of factors, such as holiday treats, travel and weather conditions that may trigger the “holiday heart syndrome”:

• Alcohol, being a vasodilator (which means it relaxes or widens blood vessels), can trigger blood pressure to rise or lower considerably and can also lead to an unexpected release of catecholamines, which are “fight or flight” hormones that can put extra stress on the heart.

• A holiday ham or turkey or processed food high in sodium can pose a serious threat to the heart — “A sudden sodium load may unmask signs and symptoms of heart disease that weren’t present before,” Dr. Rimmerman says. An excess of sodium in the bloodstream can raise blood pressure. Also, sodium can negatively impact pulmonary circulation and lead to fluid or congestion in the lungs and a condition known as congestive heart failure, especially in patients with diastolic dysfunction (the heart won’t relax sufficiently to fill with blood before it’s ready to pump blood to the body). Sodium overload also puts patients with advanced coronary disease at risk of a serious cardiac event.

• Extreme temperatures, both hot and cold, can take a toll on the heart — Recent research shows that, as the temperature drops, the risk of heart attacks increases in the winter, because cold temperatures cause arteries to constrict or narrow and that can mean reduced blood flow to the heart, as well as stress on the heart to pump blood through narrower vessels. Thus, exertion, such as shoveling snow, can put an additional burden on the heart. On the other hand, in high heat and humidity, sweating leads to a loss of fluids; this in turn means a lower volume of blood, resulting in the heart having to work harder to pump blood throughout the body.

• A long trip, either by airplane or automobile, may be included in your holiday plans — Be aware that sitting for long periods of time can raise your risk of a blood clot forming in your legs but you can take certain steps to lower that risk. “If you’re not on a daily aspirin and your doctor says it’s okay, start taking one five to seven days before you travel,” Dr. Rimmerman advises. “When you are travelling, get up and walk around every hour or so. When you’re seated, pump your legs as you’ve probably been instructed.”

Leg exercises while travelling include:

1. Foot lifts — 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.

2. Lift each knee alternately, for a brief hold.

3. Curl your toes to help keep blood flowing.

4. Extend your legs but avoid crossing your legs for more than a few moments at a time.

The heart letter suggests the following tips to avoid holiday heart syndrome:

a. Keep consumption of high-fat and high-sodium foods to a minimum.

b. Limit alcohol consumption to no more than two drinks per night for men, one for women.

c. Maintain your usual exercise routine as much as possible, even if it means doing more indoors.

d. Take more breaks than usual when doing any exercise or work outdoors and remember to take things slow and easy.
In conclusion, Dr. Rimmerman adds that if you’ve had a blood clot before, but you don’t currently have one, discuss your travel plans with your doctor who may advise you to take an additional anticoagulant or take other precautions.

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