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Alcohol and Health

What Is Holiday Heart Syndrome?

June 28, 2023
18 min read
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Reframe Content Team
A team of researchers and psychologists who specialize in behavioral health and neuroscience. This group collaborates to produce insightful and evidence-based content.
June 28, 2023
18 min read
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Certified recovery coach specialized in helping everyone redefine their relationship with alcohol. His approach in coaching focuses on habit formation and addressing the stress in our lives.
June 28, 2023
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Recognized by Fortune and Fast Company as a top innovator shaping the future of health and known for his pivotal role in helping individuals change their relationship with alcohol.
June 28, 2023
18 min read
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Reframe Content Team
June 28, 2023
18 min read

The holiday season is a time for celebration, indulgence, and relaxation. However, it can also spell trouble for our hearts. 

What is “holiday heart”? The term was first coined in 1978 to describe a sudden increase in heart-related issues during the holiday season. However, this phenomenon is not just limited to the winter holidays — it can occur during any festive period that includes excessive eating, drinking, and stress. What are holiday heart symptoms? In this blog, we’ll explore the concept of holiday heart, its causes, and how to avoid it.

Holiday Heart Syndrome: The Dangers

While “holiday heart syndrome” may sound lighthearted, its implications can be anything but. This condition can result in atrial fibrillation (AFib) (a rapid and irregular heartbeat that can increase the risk of stroke), heart failure, and other heart-related complications. 

Holiday Heart and Atrial Fibrillation (AFib)

AFib occurs when the heart's upper chambers, the atria, beat out of sync with the lower chambers. Instead of maintaining a harmonious and coordinated contraction, the atria begin to quiver, or fibrillate, resulting in a chaotic and rapid heart rhythm. This erratic behavior isn't just a simple flutter in the chest; its ramifications can dramatically affect a person’s overall health.

Common holiday heart symptoms related to AFib include palpitations, breathlessness, and fatigue. Depending on the severity of the person’s condition, these symptoms can range from mild to debilitating. The true danger lurks beneath the surface, though. When the atria are in fibrillation, they aren't efficiently moving blood into the heart's ventricles. This inefficiency can lead to blood pooling in the atria, creating an environment conducive to clot formation.

Holiday Heart and Stroke Risk

The risk of blood clots is one of the most concerning aspects of AFib. These clots can be ejected from the heart’s chambers and travel through the bloodstream. If a clot reaches the brain, it can block vital blood flow, resulting in an ischemic stroke. Strokes can lead to an array of severe neurological consequences, from paralysis to cognitive deficits. Notably, AFib-induced strokes are often more severe and more likely to result in death compared to strokes from other causes.

Beyond stroke risk, the heart's inability to maintain a regular and effective rhythm means that it can't pump blood efficiently to the rest of the body. Over time, this inefficiency can lead to heart failure. The heart begins to weaken and can't meet the body's demand for oxygenated blood, leading to symptoms such swelling of the legs, fluid accumulation in the lungs, and chronic fatigue.

Holiday Heart and Additional Complications

AFib doesn't exist in isolation. Its onset can trigger a domino effect of other cardiac issues. The rapid heart rates often seen in AFib can lead to other forms of arrhythmias, further complicating the clinical picture. Moreover, the persistent strain on the heart muscle can lead to myocardial remodeling, changing the heart's structure and function, making the affected person more susceptible to other heart diseases.

Furthermore, the persistent state of AFib can lead to the enlargement of the heart's chambers, especially the atria. This enlargement, known as atrial dilation, can further increase the risk of clot formation, creating a vicious cycle of increased stroke risk.

What Causes Holiday Heart Syndrome?

Several factors contribute to the development of holiday heart. Let’s take a look at the most common culprits.

Excessive Alcohol Consumption

When consumed excessively, especially in binge patterns, alcohol can lead to dehydration. This dehydration both reduces the volume of blood in circulation, making the heart work harder, and upsets the body's electrolyte balance. Electrolytes such as potassium, sodium, and calcium play pivotal roles in transmitting electrical signals across heart cells. An imbalance can render the heart's electrical system erratic, predisposing it to arrhythmias.

Furthermore, the cardiac muscle is not immune to alcohol’s toxic effects. With excessive consumption, the heart faces undue stress, leading to a state in which it's more susceptible to irregular rhythms. Intriguingly, not everyone needs to consume large volumes to experience these effects. Some people, due to genetic or physiological reasons, might be more sensitive to alcohol, experiencing symptoms with only moderate amounts.


Feasts and holidays seem almost synonymous. However, the pleasure of indulging in large, sumptuous meals can reap cardiac consequences. Foods particularly rich in salt can temporarily spike blood pressure. High blood pressure, even if transient, exerts additional pressure on the cardiac walls, potentially leading to arrhythmias.

Furthermore, fatty foods, especially those rich in saturated fats, elevate cholesterol levels, contributing to atherosclerosis — a condition in which arteries become narrowed and hardened. This can further compromise heart health. Additionally, consistent overindulgence can lead to weight gain, a prominent risk factor for both heart diseases and AFib.

Lack of Exercise

Exercise plays a vital role in maintaining cardiovascular health by regulating weight, reducing blood pressure, and enhancing heart efficiency. The holiday season, coupled with the chill of winter (for northern hemisphere folks), can lead many of us away from our exercise routines. 

Abandoning physical activity can lead to weight gain, pushing the heart to work harder. High blood pressure and reduced cardiac efficiency, common consequences of a sedentary lifestyle, set the stage for conditions such as holiday heart syndrome.


Holidays, while celebratory, come with their share of stressors: the pressures of perfecting celebrations, managing finances, and navigating complex family dynamics. This heightened stress stimulates the adrenal glands to release hormones such as cortisol and adrenaline.

Elevated levels of these hormones increase heart rate and blood pressure — factors known to cause arrhythmias. Moreover, chronic stress can lead to inflammation, further jeopardizing heart health.

Sleep Deprivation

Sleep is the body's natural reset button, especially for the cardiovascular system. Holidays often bring with them late-night revelries, travel across time zones, or simply the anxiety of preparations, all of which can upset regular sleep patterns.

A sleep-deprived body struggles to regulate stress hormones, leading to increased blood pressure and heart rate. Fatigue and irritability stemming from poor sleep can further escalate stress, creating a feedback loop detrimental to heart health.

Diagram about the causes of holiday heart

How Long Does Holiday Heart Syndrome Last?

In most cases, the symptoms of HHS (including palpitations, shortness of breath, or a feeling of unease in the chest) manifest within a few hours to 48 hours after heavy alcohol consumption. Their duration can vary significantly from person to person.

For many, holiday heart syndrome is transient, lasting only a few hours to a couple of days. With adequate rest, hydration, and abstaining from further alcohol or triggering foods, the heart often corrects its rhythm spontaneously, returning to its baseline state without medical intervention. This brief manifestation of holiday heart, especially in those who experience it for the first time, can make it seem unproblematic. However, even transient episodes can have implications for future cardiac health.

In some people, especially those with pre-existing heart conditions or those who have had recurrent episodes of holiday heart syndrome, the irregular rhythm might persist. AFib or other arrhythmias could continue for several days or even weeks, requiring medical intervention. In these cases, healthcare professionals might use medication or electrical cardioversion to restore the heart's normal rhythm.

It's worth noting that even after the heart's rhythm normalizes, some residual effects of holiday heart syndrome might linger. People may feel fatigued, experience bouts of dizziness, or have a general sense of malaise for a few days after the episode. 

Finally, and perhaps most critically, if repeated, even brief episodes of holiday heart syndrome can reshape the heart's electrical framework. The more frequently we experience holiday heart syndrome, the more predisposed we become to potentially more dangerous episodes in the future. This cumulative effect underscores the importance of recognizing and addressing the syndrome early.

Avoid Holiday Heart Syndrome

While the holiday season can be a time of increased risk for heart-related issues, you can protect your heart and enjoy the festivities without worry. Here are some tips for preventing holiday heart.

Limit Alcohol Consumption

Alcohol, while a staple in many celebrations, can slowly take a toll on our heart. Moderation is key! The Centers for Disease Control and Prevention (CDC) has guidelines that recommend no more than one to two alcoholic drinks per day for men and one drink per day for women. Staying within these boundaries shields our heart (and prevents a myriad of other alcohol-related complications!).

Binge drinking, characterized by consuming an excessive amount of alcohol in a short time frame, is particularly detrimental. It can lead to dehydration, electrolyte imbalances, and a transient spike in blood pressure, all of which strain the heart. If alcohol is a part of your holiday festivities, pacing your consumption and interspersing with water can make a significant difference.

Eat Mindfully

Holiday feasts can tempt us to eat more than we’d intended. While indulgence is part of the celebrations, a discerning approach to food choices can stave off potential cardiac repercussions. Foods loaded with excessive fats and salt can acutely raise blood pressure and increase the heart’s workload.

Mindfulness during meals involves being cognizant of portion sizes, savoring each bite, and recognizing satiety cues. Prioritizing fresh, whole foods and limiting processed, high-sodium options can be a game-changer. Additionally, eating substantial meals late into the night can exacerbate reflux and strain the heart, making timing as crucial as the food choices.

Stay Active

The festive season often disrupts regular exercise routines. Physical activity is paramount in safeguarding cardiovascular health. The American Heart Association recommends at least 150 minutes of moderate-intensity aerobic activity or 75 minutes of vigorous-intensity aerobic activity each week.

Holiday fitness doesn't have to be a structured gym session. Integrating activity into celebrations — a post-feast stroll, dancing the night away, or even participating in themed fun runs — ensures that the heart remains safe.

Manage Stress

The holidays, ironically, often come riddled with stress. From the pressures of executing perfect celebrations to managing year-end deadlines, stress can spike cortisol levels, inadvertently increasing our heart rate and blood pressure. Embracing relaxation techniques such as deep breathing, meditation, or even simple mindfulness practices can mitigate these effects. Setting realistic expectations, delegating tasks, and leaning on loved ones for support can also help diffuse holiday pressures.

Prioritize Sleep

Sleep is the body's natural restorative. Amid the holiday chaos, carve out your regular (we hope!) seven to nine hours of quality sleep. Practice the same good sleep hygiene during the holidays that you practice the rest of the year: regularizing sleep patterns, cultivating a serene bedtime environment, and minimizing screen time before bed. A rested body ensures the heart functions optimally, ready to participate in the festivities with vigor.

Holiday Heart Syndrome: The Takeaways

Holiday heart syndrome is a real phenomenon that can put a damper on your festive celebrations. By understanding the causes and taking steps to prevent it, you can protect your heart and enjoy the holiday season without worry. Remember to practice moderation, maintain a healthy lifestyle, and prioritize self-care during this busy time of year. Doing so not only reduces your risk of holiday heart — it also sets yourself up for a healthier, happier new year.

Summary FAQs

1. What is the recommended daily alcohol intake to protect heart health during the holidays?

The CDC advises no more than one to two alcoholic drinks per day for men and one drink per day for women to maintain heart health.

2. How can I make healthier food choices during festive feasts?

Prioritize fresh, whole foods, be mindful of portion sizes, avoid excessive consumption of high-fat, high-sodium foods, and try not to eat large meals late at night.

3. How much exercise is recommended to maintain good heart health?

The American Heart Association suggests at least 150 minutes of moderate-intensity aerobic activity or 75 minutes of vigorous-intensity aerobic activity per week.

4. What are some practical ways to manage holiday-induced stress?

Embrace relaxation techniques such as deep breathing or meditation, set realistic expectations for the season, delegate tasks, and seek support from friends and family.

5. How many hours of sleep should I aim for each night?

For optimal health, aim to get between seven to nine hours of quality sleep every night.

6. Why is binge drinking particularly harmful to the heart during festive seasons?

Binge drinking can lead to dehydration, electrolyte imbalances, and transient spikes in blood pressure, all of which put significant strain on the heart.

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