Vanderbilt Doctors Warn Against 'Merry Christmas Coronary'

by Kathy Whitney

Some studies indicate that death rates from heart attacks and stroke as well as non-heart-related causes spike during the holiday season. Researchers have coined this phenomenon “Merry Christmas Coronary and Happy New Year Heart Attack.”

“It is not uncommon to see a heavier congestion in the hospital during the Christmas and New Year’s period of time. Some years that’s very true, but some years it’s quiet,” said cardiologist Keith Churchwell, M.D., associate director of the Vanderbilt Heart and Vascular Institute.

A national database with detailed information on the 53 million deaths that occurred in the United States between 1973 and 2001 show that deaths from heart disease peak in December/January, with spikes on Christmas and New Year's Day.

Churchwell said there are several possible reasons for the spike.

People who are having symptoms of heart trouble prior to the holiday season tend to delay going to the doctor.

“They do so because of obligations at home, not wanting to spoil holiday fun, not wanting to deal with the possibility of going to the hospital and being taken care of over the holiday period,” he said. “As a result, they are less likely to see their physicians over this period of time in order to get the acute care they may need.”

In addition, some people view the holidays as a reason to take a break from their exercise and diet programs.

“Some people have spent a significant amount of time over the year trying to meet their cardiovascular goals and when the holidays arrive, they fall off their programs,” Churchwell said. “There are many explanations for this. It’s the holiday time, you get very busy, the amount of time you spend eating out and eating over at friends and family becomes more than usual. Finding excuses not to stay on an exercise regimen becomes easier to do.”

It is not uncommon for people to drink more alcohol at the holidays, which can contribute to what is known as “holiday heart syndrome.”

“Alcohol has a toxic effect on the heart muscle in a number of different ways but in particular it can lead to an irritation of the heart muscle, particularly the top chamber of the heart - the atrium,” Churchwell said. “This can lead to atrial fibrillation – an abnormal heart rhythm that is a classic finding of holiday heart.”

With the hectic nature of the holiday season, it’s easy to miss medication doses, which can lead to acute coronary trouble. Churchwell emphasizes the importance of taking medications, such as high blood pressure pills and blood thinners, with you if you travel out of town for the holidays.

He said his cardiology practice sees an increase in phone calls from patients immediately after the holidays.

“After Jan. 1 we always get a bit of bolus of patients with additional complications who have been more naughty than nice over the holiday period,” Churchwell said. “They tend to try to wait until after the holiday time with all of their issues such as they’re out of their medication so their blood pressure is elevated; they’ve been having shortness of breath or chest discomfort or swelling due to too much sodium.”

Churchwell advises his patients to enjoy the holidays, but to try to integrate the heart healthy habits they have in place with the activities of the holidays.

“If you’ve been taking a daily walk, then that’s a walk you can take with your family before or after the holiday dinner,” he said. “After the holidays it’s difficult to get back to your regular exercise and diet routine, and that puts you weeks and months behind what was, hopefully, a very good regimen of decreasing your cardiovascular risk with exercise, diet and risk modification.”

Cindy Osborn, a clinical dietitian with the Vanderbilt Heart and Vascular Institute, said that an eight to 10 pound weight gain over the holidays is not uncommon. The typical holiday meal has between 2,800 and 3,300 calories, she said.

“This would be equivalent to two day’s worth of calories for a woman who was trying to lose weight,” Osborn said.

Osborn offers these tips for staying heart healthy during the holidays:

  • Don’t try to diet to lose weight during the holidays. Rather, set a goal of maintaining weight.
  • Pick one day to eat what you want, just don’t make it last four days.
  • Avoid saving calories for an evening event so you are not tempted to overeat due to hunger.
  • Try new foods rather than going for chips and dips. If it’s something new, we tend not to take as much.
  • Don’t go to a party hungry. An hour before the party, have a snack high in protein  such as yogurt, fruit, or cheese.
  • Turkey is a good choice – it’s lean. Eggnog and alcohol, on the other hand, have lots of calories.
  • Stay away from the buffet table. Fill your plate once and step away rather than hanging around, nibbling.
  • Take a toothbrush with you. Once you eat, brush your teeth and then keep a beverage in your hand to sip on.
  • Eat slowly and engage in conversation to slow down the process of eating. It takes your brain about 20 minutes to get the signal that it’s full.
  • If you take something to the party, modify it to make it low-fat so there is at least one item that is safe to eat.
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