When Dr. David Feingold felt his heart surge into a chaotic rhythm 15 years ago, he knew instantly what was happening.
“I was drinking five or six Red Bulls a day, and I had a bad cold, and I was spraying myself with Afrin nose spray,” he recalled. “I went into atrial fibrillation. I felt it. I knew it.”
Atrial fibrillation (AFib) is an irregular, rapid heart rate. AFib causes the heart’s upper chambers to beat erratically and out of sync with the lower chambers, which can lead to poor blood flow, according to the American Heart Association.
The condition is informally known as “holiday heart syndrome” because it can be triggered by binge drinking, stress, overeating or dehydration common during the holidays, as well as factors like those that affected Feingold.
His AFib episode was treated with a cardioversion — a controlled electrical shock to reset his heart.
“Thank God,” he said.
“I haven’t had atrial fib in 15 years,” Feingold added. “But it was caused by the same mechanism that causes ‘holiday heart’: toxins.”
While New Jersey doesn’t track AFib-specific data, the national picture is sobering: AFib affects an estimated 10.5 million Americans and contributes to more than 232,000 deaths, annually, according to the Centers for Disease Control and Prevention.
Black and brown individuals have a lower overall incidence of AFib than white individuals, despite a higher incidence of risk factors such as hypertension and diabetes, according to the National Institutes of Health.
Yet when AFib does occur, research indicates that people of color experience significantly worse outcomes, including nearly double the rates of stroke, heart failure, and death. Contributing factors may include disparities in health care access, diagnosis and socioeconomic conditions.
What ‘holiday heart’ means
Feingold, a longtime cardiologist and chief of cardiology at Hackensack Meridian JFK in Edison, said his experience is a reminder of how far cardiac care has come and how vulnerable people still are to preventable triggers. He offers realistic tips to stave off cardiac events during the holiday season.
The term may sound lighthearted, but Feingold said “holiday heart” can be dangerous.
“It’s a colloquial way of expressing a toxic episode that occurs with the heart,” he said.
Most cases, he said, involve people who don’t drink regularly but take a large amount of alcohol during the holidays triggering atrial fibrillation — an irregular heartbeat that can lead to stroke.
“If there’s a clot in there, it goes forward into your head,” Feingold said.
Doctors now typically start patients on blood thinners immediately to prevent that risk.
He said alcohol isn’t the only culprit. Heavy holiday foods, especially salty dishes, which pull fluid into the heart, can also trigger symptoms.
His holiday advice: Moderation
As the season approaches, patients often tell him they can’t control their eating.
“They say, ‘Doc, the holidays are coming,’” he said. “I say to them, there’s Thanksgiving, there’s Christmas Eve, Christmas, maybe New Year’s. That’s four days. That’s no excuse.”
He said holiday food stirs emotions for many people, bringing us back to our childhood and to our ethnic backgrounds.
But he urges small portions, lighter swaps, alternating alcoholic drinks with water, and eating something before drinking to help slow absorption. For those who insist on dessert, he suggests, “Have a bite or two. That’s it.”
He also urges people to move around — take a short walk — and pay attention to symptoms.
“If you feel fluttering in the chest or any discomfort, immediately stop,” he said. “If it persists, call a doctor or head to the ER.”
Heart care has evolved
Feingold said the good news is that the treatment of heart conditions has evolved since he entered cardiology 43 years ago when options were drastically limited. He said when a patient came in with a heart attack, you sat by their bed, and you gave morphine and maybe some nitroglycerin.
“They either died or lived” he said. “You didn’t know.”
If a patient survived, he said treatment options were limited and only the wealthy had access to bypass surgery in either Texas or New York, which had hospitals offering the latest in heart care technology.
Today, the landscape is unrecognizable.
“Now you come in with a heart attack, we give drugs that prevent worsening of the heart attack,” he said. “We put new heart valves in from the skin. We put defibrillators in. Heart disease has become a chronic disease and not an acute killer.”
He also noted that early pacemakers were the size of a deck of cards and sometimes had to be recharged through the skin, which could cause the skin to heat up or even burn. Today, he said, pacemakers are about the size of a half dollar — or even smaller.
Modern monitoring tools
Thanks to new technology, patients can now monitor their own rhythm.
“The new Apple watches actually give you a printout,” he said.
A small device called Kardia also works, but he cautions that risk still depends on the individual.
“Someone older with hypertension or diabetes needs more urgent evaluation than a 20-year-old with no cardiac history,” he said.
Feingold has seen the long-term effects of alcohol too.
While holiday heart is temporary, chronic heavy drinking can weaken the heart muscle itself, causing cardiomyopathy — the deterioration of the middle muscular layer of the heart wall responsible for the heart’s contraction and relaxation. This condition is not reversible.
His message for the holidays is simple: listen to your body; enjoy responsibly; and respect what the heart can — and can’t — endure.