The holiday season between Thanksgiving and New Year’s is the busiest of the year for most families in Los Angeles. Families often spend many days in a row traveling to celebrations and gatherings. Lively performances by tired kids and small unused windows of time on family calenders illustrate the chaos. Cardiac specialists also notice this chaos and concern as they see a spike in heart-related conditions each January. Cardiac Surgeon Dr. Maria Tehrani at Ronald Reagan UCLA Medical Center stated that she sees an influx of patients in January with holiday related cardiac issues. Tehrani stated that in order to explain the reason for holiday cardiac concern one must look at the reason for concern the rest of the year.

Looking at the Data

U.S. data shows a upward trend in cardiac deaths in the months of December and peak around Christmas and New Year’s. The trend has remained steady in various studies for decades.

The correlation with weather is obvious in most of the country as the weather gets colder and blood vessels constrict, however, the same trend has been shown in Los Angeles County where the weather does not get that cold. Los Angeles County has a higher rate of coronary deaths in December and January compared to the summer months. Other behavioral contributing factors may explain the correlation.

Why Do People Delay Seeking Care?

The simplest explanation is usually the most correct. People often develop symptoms during the holidays and decide to delay seeking care.

No one enjoys being the person that ruins the holiday dinner to go to the ER. Many other plans are canceled and delayed to make time for the holiday celebrations. People often ignore symptoms in an effort to enjoy their plans, and many people decide to see how they feel after the guests leave.

For a person having a heart attack, it is often determined how much muscle can be saved by how quickly they are able to receive help. Many of the patients Dr. Tehrani sees in January have warning symptoms of a heart attack for a week or more.

Often, symptoms of other more serious problems also go undetected. Many people travel during the holidays and lose access to their regular doctors. Often many of the regular and prescribed medications that people need to control their conditions also go undelivered. Many healthcare offices are closed and scheduled appointments are delayed. A big disruption to a regular routine, can be dangerous for people suffering from cardiac issues, especially if they are traveling across time zones.

Food is usually saltier and in larger portions at restaurants and during the holidays. People with heart failure or uncontrolled hypertension are at risk to retain fluids and breathe dyspneaic from a relatively short period of time consuming high salt loads.

Decompensation is caused by a combination of factors including loss of routine, emotional stress, increased work load, excess alcohol, and lack of exercise. Many people with no history of cardiovascular disease have symptoms and episodes of atrial fibrillation and other arrhythmias triggered by heavy alcohol consumption during the holidays.

Stress, exertion and emotions are also triggered during the holidays. Hosting and feeding guests during the holiday season increases emotional stress and leads to a higher likelihood of a cardiovascular event.

The holidays can trigger grief, loneliness and emotional stress. For many, the grief and emotional stress of the holiday season is worse due to the absence of a deceased family member. The emotional stress and grief is a trigger for cardiac events. The increased work load of holiday travel and the emotional stress of family gatherings can also trigger cardiac events.

Overlap of Respiratory Illnesses

Respiratory illnesses like influenza and RSV are at their peak during the same season, especially as people travel and attend large events. It’s also been shown that having a respiratory illness can increase the risk of a heart attack, and can be more dangerous to those with pre-existing heart conditions. People can also contract an illness from a large event and give it to family members who can then develop a cardiac problem.

Protect Your Heart This Season

There are a few things the average person can do to be proactive about their health this season.

Bringing your medication with you in your carry on can also be helpful in case your checked baggage gets delayed. A written copy of your medications, condition and doses can be useful in the event your bag gets lost.

Try to gain some control over your health while visiting family. Keeping your diet low in sodium can help if you have heart failure or high blood pressure, and gaining weight from fluid retention can be measured by weighing yourself.

Maintaining your normal diet and routine can help if you gain weight from fluid retention. A daily walk can help lose some fluid and gain a sense of control over your health and routine.

It’s also helpful to locate the nearest emergency room if you plan to travel. Be on the lookout for any symptoms your elders may have because they are least likely to complain.

When to Get Help

If you have chest pain, pressure, or tightness that lasts longer than a few minutes, call 911. Other symptoms that require immediate medical attention include, but are not limited to, pain spreading to your arm, jaw, neck, or back; shortness of breath; cold sweats; nausea; lightheadedness; or weakness.

Women and people with diabetes typically experience less obvious symptoms, including shortness of breath, nausea, and exhaustion.

If you have symptoms of a cardiac emergency, don’t try to drive yourself to the hospital and don’t delay going to the hospital thinking you’ll go after your visit or event.

If you’ve previously had heart problems and have not been to see your doctor in the last year, it’s probably time to go.

Other circumstances that necessitate an evaluation of your heart health are breathing problems with activity, inability to control your blood pressure and/or heart health concerns, and if you have known heart issues and are planning a long trip.

If you are planning a trip after a recent procedure, please consult with us to assess if you’re cleared to travel.

Maria Tehrani, MD | Cardiac Surgeon

For further information, or to schedule an appointment, call (818) 350-9899 or email welcome@mariatehranimd.com.