A student turned traveller turned up at the FMP clinic on Saturday night at 10.45pm with pains across the chest and an uncomfortable heartbeat; he’d spent the day with friends walking the streets of Hanoi looking at some of the old buildings and having great fun. He told the staff he’d had a few late nights with friends drinking the local beers and enjoying the new tasty food. He was having a really great time; but now he felt strange with pains and dizziness.
Welcome to Holiday Heart Syndrome
You are on holiday, first time in Asia and there are always lots of reasons to celebrate and enjoy the holiday spirit. Unfortunately, it is often a time in which many people end up going to the emergency department because of too much holiday in the heart. We often see patients presenting themselves with atrial fibrillation or a very rapid abnormal heart rhythm in the upper heart chambers associated with symptoms of palpitations, shortness of breath, chest pain, light-headedness, stroke and heart failure.
Factors & Causes?
The honest answer is we don’t fully know. Dehydration; change of temperature, new food, food additives, coffee, alcohol, MSG and tiredness are just the start of the contributing factors.
Several factors may contribute to Holiday Heart syndrome.
Over-Eating. Eating a large amount of food at one sitting causes the stomach and bowels to stretch and distend to accommodate it. This activates the nervous system in our body called the vagal or parasympathetic nervous system we use to digest food, rest and sleep. This nervous system, when activated, typically slows the heart rate. However, in people susceptible to atrial fibrillation, small areas in the upper chambers of the heart are actually triggered and beat very fast, leading to the abnormal heart rhythm. These areas often reside in the small veins that drain blood from the lungs into the left upper heart chamber.
Salt Consumption: Our bodies need salt, but when we consume a lot of salt our bodies can retain fluid and our blood pressure can rise. In people with a history of high blood pressure, heart valve problems, or heart failure, the increase in blood pressure and higher amount of fluid in the body stretches the upper heart chambers, and atrial fibrillation develops.
MSG & Food Additives: Sensitivity to particular food additives can also give you reactions like hives or diarrhoea. This doesn’t mean all foods containing additives need to be automatically treated with suspicion, as foods with naturally occurring chemicals can also cause issues. Many food additives occur naturally within foods people eat every day; for example, MSG is found naturally in Parmesan cheese, sardines and tomato. People with food allergies and intolerances are also often sensitive to chemicals found naturally in certain foods, such as nuts or shellfish.
Everyday foods that contain natural MSG or glutamate include: corn, green peas, grapes, grape juice, mushrooms, Parmesan, Roquefort, tomatoes and tomato juice.
How to Stay Safe?
If you have a history of heart symptoms, go to the hospital early. Take everything in moderation and avoid excess. Try to minimize eating large quantities of food at once. Avoid adding salt to your diet and finally, if you know someone who is depressed, alone, or isolated during the holiday season, reach out and cheer them up, it may be the best thing you do for them.
But there are worse things to fear than food additives.
In Asia many people view food additives as a major food threat. However, in terms of health risk, food additives come in at the end of the line, after food-borne microorganisms (like salmonella), inappropriate hygiene and eating habits, environmental contaminants and naturally occurring toxins.
Dr Michael Santos is a general practitioner at Family Medical Practice Hanoi. For information or assistance call (04) 3843 0748 (Hanoi), (08) 3822 7848 (Ho Chi Minh City) or (0511) 3582 699 (Danang). Alternatively, click on vietnammedicalpractice.com