The risk of having a heart attack or stroke rises during the holiday season, with a spike in cardiac deaths between Christmas and New Year's. "We definitely see it in the ER over the holidays," says Dr. Donald Lloyd-Jones, a cardiologist who leads the Framingham Heart Study at Boston University School of Medicine.
So what's causing the Christmas Coronary effect and how can you reduce your risk?
Lloyd-Jones says risk factors that put people in danger are present year-round, but the holidays can serve as a tipping point when multiple factors converge.
"Certainly the weather is a contributor, and also things like the infections that get us during the winter time, changes in our lifestyle, disruptions in our routines, and also the stress of the holiday season," Lloyd-Jones says.
Too much merry-making with rich foods and alcohol can strain the heart. And numerous studies show excess sodium increases blood pressure, forcing the heart to work harder.
And though stress is ever-present, an acute stressor that activates the fight-or-flight response, brought on by an argument or difficult situation, could exacerbate the situation, creating a perfect storm.
"When we're under acute stress, things like our blood pressure can spike and that puts extra strain on the cardiovascular system," Lloyd-Jones says.
Some people mistake heart attack symptoms for indigestion or overeating. Here are the classic warning signs:
"Sudden onset, usually of heavy pressure in the middle of the chest or sudden unexpected shortness of breath," explains Lloyd-Jones. "Those are really two cardinal symptoms that people should never ignore."
Sometimes the signs are more subtle. "It's important to remember that not everyone has textbook symptoms, especially in women," says Dr. Tina Shah, a cardiologist based in Seattle with Kaiser Permanente. She points to feeling lightheaded or experiencing pain in the jaw, neck, or back, which may be radiating from the chest.
Research shows the risk of stroke also rises this time of year, and strokes present differently than heart attacks. To spot signs, there's a mnemonic device known as FAST.
"If you notice facial drooping, which is the F, or if you have arm or leg weakness on one side or sudden speech difficulty, then it's time to call 911" fast, says Lloyd-Jones.
Amid holiday travel and gatherings, healthy habits may fall by the wayside. With disrupted routines, people may forget medications, such as heart and blood-pressure drugs, says Dr. Luke Laffin, a preventive cardiologist at the Cleveland Clinic.
"It's important to make sure that you have enough medicines for your entire trip," Laffin says, and if you're flying, pack them in your carry-on so you're not stranded without them if checked luggage goes missing.
As a physician, Laffin has witnessed the rise in admission to the ER during the holidays. He stresses the importance of not delaying or avoiding care. Some people talk themselves out of going to the ER, thinking symptoms will pass, which could be a mistake.
"No one's ever going to fault you for going to the emergency department if your symptoms are concerning enough," Laffin says.
Often, when people suspect a heart attack, that's exactly what it is. And seeking prompt treatment is key.
"If someone comes to the hospital with an ongoing heart attack, the more quickly we restore blood flow with a stent, it can make the difference between someone living essentially a normal life versus living their life with heart failure," Laffin says.
Bottom line: It's better to be safe than sorry.
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