Holiday Heart Syndrome

definition

The term Holiday Heart Syndrome is understood to be the cardiac arrhythmia caused by alcohol abuse. The Holiday-Heart-Syndrome belongs to the category of arrhythmias which are caused by extracardiac factors. Among other things, there are a few other arrhythmias, especially paroxysmal atrial fibrillation.

This means an "attack-like" occurrence of a pathologically increased atrial frequency between 350 and 600 / minute. The result is unproductive contractions in the atrium of the heart and, associated with this, reduced blood flow into the heart chamber. The name of the Holiday Heart Syndrome goes back to the sudden appearance of the symptoms described, especially on or after vacation or non-working times due to excessive alcohol consumption. The symptoms therefore often only appear in the recovery phase after strenuous leisure activities.

Causes of Holiday Heart Syndrome

Some trigger factors for this clinical picture can be found in interaction with alcohol.
The most important are:

• alcohol
• Stress: Both psychological (e.g. loud music or large crowds) and physical stress (e.g. lack of sleep) favor the occurrence of the symptoms described above.
• To celebrate

Above all, a stress-related lifestyle with all its facets should be the cause of the clinical picture. Most of the people affected by this clinical picture are heart-healthy, which is why a spontaneous relapse into the normal heart rhythm can often be observed.
Nevertheless, there are some predisposing pre-existing conditions that can increase the likelihood of occurrence. These include the typical cardiovascular stressful diseases such as arterial hypertension, pre-existing cardiac insufficiency, obesity, diabetes mellitus, a history of myocardial infarction or chronic lung diseases.
A genetic component with possible inheritance has also been described.

Symptoms of Holiday Heart Syndrome

It is represented with an overall prevalence of 1-2% in Germany and is therefore the most common cardiac arrhythmia.
A symptom-free course is observed in a third of the cases.
The remaining two thirds show possible symptoms:

• Palpitations and racing heart
• Shortness of breath with shortness of breath
• irregular pulse
• Dizziness with consecutive syncope
• Fear combined with inner restlessness and increased sweat production
• Symptoms of heart failure

Heart failure ("weakness of the heart muscle") occurs, however, especially when chronic atrial fibrillation is present. This is the existence of the rhythm disturbance from weeks to over a year. Nevertheless, there is a risk of complications of thrombus formation with atrial fibrillation. This comes about through the uncontrolled contraction movements in the atrium and is potentially life-threatening. After a thrombus in the atrium of the heart has loosened, it can e.g. clog the arteries of the brain, leading to a cerebral infarction.

You can find more about the symptoms at Symptoms of heart failure

Diagnosis of Holiday Heart Syndrome

In addition to the anamnesis, clinical and apparatus diagnostics can also be considered. In terms of anamnesty, it is important for the doctor to determine the possible trigger factors: alcohol consumption during excessive partying combined with cardiac symptoms, as described above. In the course of the diagnostic apparatus, the attending physician uses the EKG. Irregular or irregular time intervals and possibly asynchronous heart excitations between atrium and ventricle (e.g. missing p-wave) are noticeable here.

Therapy of Holiday Heart Syndrome

In terms of therapy, there is the option of drug anticoagulation ("blood thinning") and frequency control. The focus is on the effect of specific antiarrhythmics such as the amiodarone. Standard preparations such as ASA etc. can be used for anticoagulant purposes. Holiday heart syndrome with the occurrence of atrial fibrillation can also be treated surgically.
In this case, attempts are made in principle to reduce the triggering of atrial fibrillation by ablation ("sclerotherapy") of the detected atrial cells that are causing it. As a prophylactic measure, in addition to a balanced lifestyle with moderate stress, a healthy diet is also recommended.

In the long run, foods rich in fat and low in fiber lead to those clinical pictures which, as previous illnesses, favor Holiday Heart Syndrome. In addition, a few basic rules can be established for prophylactic purposes. In summer, staying in the midday heat between 11 a.m. and 3 p.m. should be avoided. The interaction of strong sunlight and the consumption of alcoholic beverages and energy drinks put a heavy strain on the heart. When celebrating, you should make sure to consume water or unsweetened teas as a balance in addition to alcohol consumption.

The prognosis and duration of Holiday Heart Syndrome

Typically, rhythm normalization occurs within 48 hours to a maximum of 7 days.
As a rule, the Holiday Heart Syndrome is a disease with a favorable prognosis. Since people with structurally healthy hearts are particularly affected, this seems to be an acute stress reaction of the heart, which is not directly life-threatening if the course is uncomplicated. A spontaneous conversion to sinus rhythm when atrial fibrillation occurs can be observed in most cases.
Nevertheless, in a few cases and especially when excessive partying and other everyday stress persists for a long time without recovery phases, secondary diseases of the heart such as persistent atrial fibrillation.