Holiday Heart Syndrome Clinical Presentation

Updated: Aug 31, 2017
  • Author: Adam S Budzikowski, MD, PhD, FHRS; Chief Editor: Jose M Dizon, MD  more...
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Patients with acute exposure to alcohol can present with a variety of symptoms.

Palpitations are the most common symptom. These can be intermittent or persistent, depending on the presence or absence of sustained arrhythmia and the ventricular response to atrial fibrillation. Patients with rapid ventricular responses can present with near syncopal symptoms, dyspnea on exertion, and angina.

Patients often have a history of previous alcohol exposure. This often occurs in binges on weekends, during vacations, and, of course, on holidays. A history of alcoholism should alert physicians to concomitant illnesses such as alcohol-related cardiomyopathy and chronic liver disease. These coexisting illnesses have important prognostic implications and affect patient management.


Physical Examination

On physical examination, the patient may show signs of alcohol intoxication and have alcohol on the breath. Depending on the cardiac rhythm, the patient may have an irregular or thready pulse. Cardiac auscultation is usually normal except for possibly irregular and/or rapid heart tones. Mental status may be impaired consistent with alcohol intoxication.