Holiday Heart: Why Palpitations Spike in December

Call 911 for chest pain or pressure, fainting, severe breathlessness, or a
racing heart with light-headedness. Those are not things to sit out, whatever
the date.

And the sentence this whole page exists for: do not postpone a heart symptom
because it is a holiday. We are open on the 25th, on New Year's Eve, and at
4am on a Sunday. A cardiac symptom you decide to deal with after the family
leaves is the single most expensive decision in this article.

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What "holiday heart" actually is

A pattern doctors have described for decades: an episode of an irregular
heartbeat — usually atrial fibrillation — in someone with no heart-rhythm
history, in the days after heavy drinking.

It does not require a lifetime of heavy drinking. A single big night can do
it, which is why it clusters around holidays, weddings and long weekends.

What it feels like:

• A fluttering, racing, thumping or skipping sensation in the chest or
  throat
• Breathlessness, especially on mild effort
• Light-headedness or feeling you might faint
• Unusual tiredness
• A pulse that feels irregular if you take it
• Sometimes nothing at all — some people only find out at a routine check

Alcohol is the classic trigger, and it is not the only one: dehydration, a
salty meal, very little sleep, caffeine, stress, and an infection all
contribute. In December people frequently do all of those in the same
forty-eight hours.

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Why a new irregular heartbeat gets assessed rather than waited out

Not because the sensation itself is dangerous — it is usually not, and many
episodes settle on their own within a day.

Because an irregular rhythm changes how blood moves, and that raises stroke
risk while it lasts. That risk is manageable once somebody knows about it,
and it is the reason this is worth a visit rather than a wait-and-see.

So the useful rule: a fluttering heart that settles in ten minutes and has
happened all your life is different from a new one that has gone on for hours.
The second gets checked.

Get checked today if:

• It is new, or different from your usual pattern
• It has lasted more than a few minutes, or keeps returning
• It comes with breathlessness, chest discomfort, dizziness or fainting —
  or if it does, call 911 rather than driving
• You have had a stroke or a clot before, or take a blood thinner
• You already know you have an irregular rhythm and this episode is
  behaving differently

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The other December problem, which is behavioural rather than cardiac

People delay. There is a house full of relatives, a meal half-cooked, an
expectation not to spoil the day — and a symptom that would have sent someone in
on a Tuesday in March gets negotiated with until the 27th.

Every emergency department knows this pattern. So, plainly:

• We are open every day of the year, including the ones you are worried
  about interrupting. Nothing about arriving on a holiday is unusual for us.
• You are not spoiling anything. A few hours of a relative being checked is
  a considerably smaller disruption than the alternative, and everyone in that
  house would choose it.
• If you are the relative noticing rather than the person affected, say
  something. People underplay symptoms in front of family, and the person who
  insists is frequently the reason someone came in.

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Reducing the odds, without a lecture

• Space out the drinks and alternate with water. Volume in one night is what
  the pattern keys off.
• Rehydrate deliberately, which matters more here than in most of the
  country. Dehydration
• Sleep, which is the one people sacrifice first and which independently
  provokes rhythm problems.
• Go easy on the salt if you have blood pressure or heart failure — a
  holiday table is a lot of sodium in two days.
• Take your usual medication on the usual schedule. Routine slips over
  holidays and missed doses are a genuine contributor.

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What happens when you arrive here

• A physician sees you — board-certified, every visit, at every hour.
• An ECG, which is what identifies a rhythm problem and is available here at
  any hour on any date.
• Blood tests in our own laboratory, which come back during the visit.
• A critical care room here for the presentations that need one.
• Monitoring for up to 24 hours, which matters for rhythm problems
  specifically — an irregular rhythm that comes and goes may not be present
  in the first ten minutes, and being watched is how it gets caught.

If you need admission, a cardiologist, or a procedure to restore the rhythm,
we stabilise you and arrange the transfer. We are an emergency room, not a
hospital.

What helps us most: when it started and whether it has stopped, what you
drank and when, whether you have felt it before, your medication list, and — if
you can — your pulse taken by hand or a reading from a watch. A recording
from a wearable during an episode is genuinely useful, even though it is not
diagnostic on its own.

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El Mirage ER — open 24 hours a day, 7 days a week, 365 days a year.
12000 N El Mirage Rd, El Mirage, AZ 85335 · (480) 237-4922
Walk in. No appointment, no referral.
If this is a medical emergency, call 911.

This article explains when to seek emergency care. It is not medical advice and
cannot account for your history, your medications, or what is happening to you
now. If you are unsure, call us or call 911.

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Sources

The guidance in this article about when to seek emergency care is drawn
from these public sources. Each one is linked so you can read it yourself.

• MedlinePlus (National Library of Medicine) — Heart Attack — https://medlineplus.gov/heartattack.html

This article is general information, not a diagnosis, and it cannot account
for your history or medications. If you are unsure, call us on (480) 237-4922
or come in. If it might be an emergency, treat it as one and call 911.

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