Tuesday, January 1, 2013

Holiday Heart (Marin IJ)

Twas the day after Thanksgiving, and all through the house, not a creature was stirring, not even an over-sized spouse. The empty bottles lay strewn all around without care, a sure sign that black out Friday was already there. When inside your chest there arose such a clatter, an odd pounding of the heart, which seemed to mean something was definitely the matter. Up from bed you flew in a flash, and off to the cabinet for the aspirin stash.  And then, with a palpitation, you recall what’d your heard, of an irregularly irregular heartbeat louder than a large bird. The answer buzzed in your head and turned you around, in your chest a case of ‘holiday heart’ had surely been found.
To the phone you went, moving none to quick, as you knew in that moment that you must phone Doctor Tick. More rapid than hummingbirds, his answers they came. And he whistled, and sniffled, and called the possible rhythms by name!
“Could be Afib! Or Flutter, or rapid rate due to Hyperthyroidism! Could be PVC or SVT, or much less likely something secondary to pulmonary embolism! But the cause of the problem, yes the cause of it all, is most certainly, yes most certainly, your excessive intake of alcohol.”
After this information settled and you’d stifled a cry, you took a deep breath, and asked Doctor Tick…Why? So ear to phone, you listened as his answer it flew. Not too sure, he said, could be changes in body stress hormones, or effects of fatty acids too.

And then, in a twinkling, you heard his voice, reciting epidemiology, and you had no choice.  Atrial fibrillation, that is Afib, he said, is the most common by far. That common rhythm caused by an irregular atria, is often picked up at a bar! The numbers in studies jump all around, but up to a 35% linkage of new Afib and alcohol use has been found.
So there it was, the diagnosis as clear as day, and now all that was left was to ask Doctor Tick how you could make it go away. It may pass, he said, it may pass real soon, but I’m afraid my friend that you must listen to my cautionary tune.
“Now fluids, now rest, now abstention and healthy meal-fixing. On aspirin, on pulse monitoring, on moderation and no cocktail-mixing. To the ER you should go if your chest feels tight. Or if you have difficulty breathing, dizziness or your palpitations last all through the night! And recall my friend, that your body handles holiday stress when it is at its best: exercise, eat well, and get plenty of rest.

And as he was speaking, as quick as whistle, away the flutters flew like the down of a thistle. And I heard Dr. Tick say, in my head ‘ere that night. Happy Holidays to all but for alcohol and holiday heart, let’s say good night!

Author’s notes; First, a hearty thanks to Clement Moore for setting the metronome for this column. Second, holiday heart refers to a diverse population of heart arrhythmias – some benign and some more sinister.  The most common of these is atrial fibrillation – a widespread arrhythmia that has many possible causes and triggers, of which alcohol is just one. Among the other causes; abnormalities with the arteries or valves of the heart, acute infections, disruption of hormonal mechanisms like the thyroid, and, as we learned recently, coaching an NFL franchise. Thus, those suffering from an irregular heartbeat, especially one associated with chest pain or shortness of breath, should not wait long before consulting a physician.