Holiday Heart Syndrome, Heart Attacks Spike Risks Around Holidays

Doctors explain why the end of the year, especially Christmas Day, can be tough on your ticker

Updated December 19, 2025

Comments

En español

Published December 16, 2021

/ Updated December 19, 2025

Stethoscope on a wood background surrounded by Christmas decorations

For most of us, the holidays are a time of celebration. But along with all the roasted ham and spiked eggnog, there are two heart health concerns linked to the season: increased risks for holiday heart syndrome and heart attacks.

Holiday heart syndrome occurs when you partake in binge drinking and develop temporary atrial fibrillation, or A-fib (irregular heartbeat), and other tachyarrhythmias (fast heart rhythms) as a result of having alcohol. The syndrome is also linked to heart attacks.

According to the Cleveland Clinic, you’re more likely to develop this syndrome if you:

Have high blood pressure, diabetes, sleep apnea or obesity
Have an existing issue with your heart or its structure (including valves)
Are male and white

Symptoms of holiday heart syndrome include heart palpitations, fatigue, chest pain, shortness of breath and weakness.

Holiday heart syndrome may be more problematic with age because older adults, especially those 65 and older, tend to have a higher likelihood of sustained A-fib, more symptoms (like shortness of breath) and a reduced ability to convert back to their regular rhythm because of other health ailments, says Dr. Michael Miller, a cardiologist at Philadelphia’s Penn Heart and Vascular Center.

This can increase the risk of complications, including stroke, he says. As a result, the older you are with holiday heart syndrome, the more likely you need formal rhythm control measures and treatments, he adds.

Holiday heart syndrome isn’t the only holiday-related health ailment. Research shows that more people die from heart attacks during the last week of December than at any other time of the year. According to a study published in the journal Circulation, more cardiac deaths occur on Dec. 25 in the United States than on any other day of the year, followed by Dec. 26 and Jan. 1.

“No one wants to think of tragedy during this joyous time of year as we gather with family and friends,” says Dr. Johanna Contreras, a cardiologist at New York City’s Mount Sinai Health System. “However, these startling facts are very sobering. We don’t know exactly what triggers this increase in heart attacks during the holidays. It’s likely a combination of factors.”

In fact, the number of heart-related deaths in the United States increases by about 4 percent during the December and New Year holidays, according to a 2016 study published in the Journal of the American Heart Association. A 2018 analysis published in the BMJ (British Medical Journal) found that the risk of having a heart attack is about 37 percent higher on Christmas Eve. People over 75 and those with chronic health conditions such as heart disease or diabetes are at greater risk.

“During December, people take a holiday from taking care of their health, which isn’t good for their hearts,” says Dr. Nieca Goldberg, medical director of Atria NYC and a clinical associate professor of medicine at New York University.

Scientists aren’t sure how alcohol can lead to heart rhythm abnormalities, but drinking can interact with the heart’s electromechanical activity. It may affect the heart indirectly, as vomiting from alcohol could disturb electrolyte levels that affect the heart. Your chances of getting holiday heart syndrome go up the more you drink, the American Heart Association (AHA) says.

Why the holidays are harmful

This time of year can be so tough on your ticker for a few reasons. They include:

Stress. Whether it’s the bustle of holiday travel or feeling financially overstretched from shopping for gifts, this time of year can put a lot of strain on your body. “When you’re stressed, your brain produces more stress hormones such as cortisol, which are bad for heart health,” says Dr. Donald Lloyd-Jones, a professor at Boston University’s Chobanian & Avedisian School of Medicine and a former AHA president.

In fact, people with high levels of cortisol are five times more likely to die of a heart attack or stroke, even if they don’t already have heart disease, according to research published in The Journal of Clinical Endocrinology & Metabolism.

Most Popular

Depression. A 2020 study published in JAMA Psychiatry found that deaths from heart disease increased by 20 percent among people with at least four symptoms of depression, compared with people without them.

“The holidays are hard for older adults, who may not have as much social support as they did when they were younger and thus feel lonely and isolated,” says Waqar Khan, an interventional cardiologist and author of Be Heart Smart: Understand, Treat, and Prevent Coronary Heart Disease.

And the same emotions that leave you feeling anxious and frazzled can also raise levels of hormones such as norepinephrine and adrenaline, which in turn can raise your blood pressure and heart rate enough to boost your heart attack risk.

Skimping on health. You may find yourself so busy this time of year that you forget to take your medications or have trouble getting to the pharmacy to refill them, says Dr. Nicholas Ruthmann, a cardiologist at the Cleveland Clinic. If you do have unusual symptoms, like chest pressure or shortness of breath, you may be more likely to put off treatment amid the flurry of all the holidays, he adds.

Too much food and drink. A heavy, high-fat, high-salt meal doesn’t just tax your digestive system. It also raises your blood pressure and heart rate, Goldberg says. A 2023 study published in JAMA Network Open found that consuming even as little as one drink raises the risk of A-fib, which affects over 13 percent of adults over the age of 65.

“We see a lot of older patients with existing atrial fibrillation who end up in the emergency room with an arrhythmia after a few drinks,” Goldberg says.

Even if you don’t have atrial fibrillation, excess alcohol intake can ramp up your blood pressure and blood sugar, raising the risk of heart attack or stroke, she adds.

How to stay safe

If you have heart disease — or have risk factors for it — you don’t have to put the kibosh on holiday celebrating entirely.

“We do know there are ways to mitigate your risk for a deadly heart attack. So we encourage everyone to pause during the holiday hustle and bustle and make note of these important steps that could be lifesaving,” says Contreras, who is also a clinical volunteer for the AHA.

Here are seven things that can help make this time of year safer.

1. Plan ahead to make sure you have your medications on hand

If you know you’ll need medication refills, order them in advance so you aren’t racing to pharmacies during the holidays, Lloyd-Jones says. If you’ve been putting off a doctor visit to check blood pressure, or lab work to check cholesterol or blood glucose levels, do it now.

2. Bundle up against the cold

The frigid temperatures can affect your heart, especially if you already have heart disease. “Cold air can raise blood pressure and also slow down the flow of blood to the heart, which can lead to angina, or chest pain,” Goldberg says.

A 2018 study published in JAMA Cardiology found a big jump in heart attacks in the cold weather, especially when the temperature dips below freezing. Goldberg recommends that you cover your mouth and nose with a scarf to help warm the air you breathe.

3. Don’t overindulge on holiday meals and treats

Resist the urge to pig out. One study of almost 2,000 heart attack patients found that a single act of overeating could quadruple the chance of having a heart attack on the same day.

At holiday celebrations, Goldberg recommends that you skip foods heavy in saturated fat, sugar or salt and limit yourself to one cocktail throughout the evening. Binge drinking has been linked to holiday heart syndrome.

“When you drink too much alcohol, you can worsen atrial fibrillation,” which causes irregular heartbeat and is present in many older adults, says Khan.

Consider a post-meal walk too. A short walk after eating lowers blood sugar levels more than walks before a meal do, according to a 2018 study published in the medical journal Nutrients.

4. Keep up healthy habits

Make a pact with yourself during the holidays that you’ll do something good for yourself every day, whether it’s staying active, getting enough sleep or eating a healthy breakfast every morning. “If you commit to taking care of yourself, you’ll be less likely to slip up with unhealthy habits like smoking, drinking too much or overeating,” Goldberg says.

5. Avoid overexertion

Unless you’re in great physical shape, leave the shoveling to a younger family member. Otherwise, if something feels like a physical stretch for you, think twice about taking it on during the holiday red zone.

Snow removal can trigger heart attacks. Nearly 200,000 people were treated in emergency rooms for incidents related to snow shoveling from 1990 to 2006, according to a study published in The American Journal of Emergency Medicine. All of the 1,647 deaths recorded in the study were cardiac related.

6. Listen to your body

According to the AHA, the biggest increases in holiday heart attack deaths are among people who are not in a hospital, so it’s important to recognize the symptoms of a heart attack and seek care immediately.

“Don’t ignore heart attack warning signs because you don’t want to spoil the holidays. The consequences could be much worse,” AHA Chief Clinical Science Officer Mitchell S.V. Elkind said in a news release.

Symptoms of a heart attack can mimic how you feel after you eat a big meal or rush around, says Ruthmann. Pay attention if you experience signs like shortness of breath or chest pains, especially if these don’t occur right after you’ve eaten. If you notice these, let your doctor know right away.

“We find that a lot of people ignore symptoms because they don’t want to miss a certain family dinner or holiday event,” Ruthmann says. “The best gift you can give yourself is to focus on your health.”

7. Brush up on CPR

The uptick in heart attacks this time of year “also calls attention to the need for increased awareness of knowing how to perform hands-only CPR,” Elkind says.

“You could be out holiday shopping, enjoying an office party or spending time at a family gathering and witness someone having a heart attack and going into cardiac arrest,” he continues. “Starting CPR immediately and calling 911 could be the difference in life or death in those situations. Hands-only CPR is something nearly everyone can learn and do.”

The AHA has hands-only CPR tutorials on its website.

Editor’s note: This story, originally published Dec. 16, 2021, has been updated to include new information. 

%{postComment}%