Holiday Heart Syndrome

Hi Doc,

Background to my situation:

29 y/o male - about 3 weeks ago i woke up at 5am with an irregular heartbeat.  I went to the docs as soon as it opened and did an ecg which showed a resting heart rate of 183 and afib.  

He referred me to a cardiologist the same day, who i saw about an hour later.  He confirmed atrial fibrillation and said he had to admit me to ICU as he had to shock my heart (cardioversion?).  Anyway i am quite overweight - 140kgs and have high BP.  When i went to see the Cardiologist my BP was 165/110 and gave me a stat dose of Xanax (at my request), asprin, and betablockers (cant remember which ones).

I was then admitted to the ICU where i remained for 4-5 hours.  The cardio then informed me that he did not have to do the shock treatment as one of the beta blockers had put my heart rythym back to normal.  I was also given a blood thinner (heparin?).  I was then transferred to a normal room and discharged the next day.  Prescribed asprin/Glycerine for thenext 42 days and Diovan 160.

The doctor tells me that i had Holiday Heart Syndrome (not helped by the fact that i am overweight and have high BP) as for the 7 days prior to this i had been drinking heavily every day, and eating badly.  I have since made a complete lifestyle change, lost 4kgs, stopped drinking, eating properly etc.  My BP has fallen to avg of 124/78 over the last week.    My questions are as follows:

1.  I do not feel 100% comfortable with my cardiologist as his first response was to give me the cardioversion when it is clear that medication can solve the problem without this treatment.  It would also seem that it can resolve itself.  Would you agree?

2.  Do you think my treatment was over the top?

3.  I am committed to living 'heart healthy' going forward, but i do enjoy a couple of beers every now and then with friends.  Is it ok to do this? Will I  retrigger this by having a few drinks or will it take a big binge again?

Many thanks

J

[Michael J. McWilliams, M.D.]

Medication does not always work to terminate atrial fib.  Someone your age often terminates on your own after a few hours.  It was probably a coincidence that it termated after the beta blocker and may have terminated on its own anyway.  There are many ways to solve the problem --  planning for a cardioversion is a reasonable option but not the only option.  I would say it was very responsive of that cardiologist to see you within the hour -- they could have told you to go the ER and that would have been a much more unpleasant experience of waiting.

I do not think your treatment was over the top, just one of many choices.



Only time will tell what it takes to cause another episodes if it ever happens again.  At your age it is usually binge drinking but I have seen some patients that have atrial fib every time they have drink.  I would advise moderation with alcohol and if it happens again while drinking you may need to cut back further -- no more than 2 drinks in any 24 hour period.

I hope this helps.

[jamiegutz]

Thank you doctor.  

Yes it was very responsive to see me that quickly.  I was fortunate enough to be in a reputable, private hospital and so the Cardiologist was able to see me quite fast.  

The reason i sound a little skeptical is that i am and expatriate living in Asia and you often hear stories of *some* hospitals over treating in order to charge more.  This has never happened to me though, and clearly (thanks to your input) it was not the case in this instance.

I will keep the drinking to a minimum and see how it goes.  With christmas around the corner i think it will be a bit of a challenge but i can only do my best!

THanks again Dr, and merry christmas and best wishes for 2009.

J

[starshell]

A related discussion, holiday heart syndrome was started.