Thank you for your query at DoctorSpring. Com
You are experiencing missed beats. It could be due to ventricular or atrial premature contractions. However it can be said to be the cause with surety only after documenting these beats on ecg. So if your ecg shows pacs or pvcs or correlates with your symptoms then it is most likely the cause of your symptoms. If your symptoms do not occur during the time of ecg then a 24 hour holter examination may capture the abnormality. If you could run a marathon without undue shortness of breath and chest pain it is unlikely that you have any significant coronary artery disease. However for the evaluation of pvcs or apcs a 2d echo may be done and if normal these beats do not carry much significance. They could be due to anxiety as you said.
Holiday heart syndrome is due to excessive binge drinking of alcohol. Is that the case?
Dr Vivek Mahajan
Patient replied :
Thank you for your response,
After sending the email, I slept for a full 7-8 hours and am no longer experiencing any symptoms.
On the question of binge drinking, yes I have been drinking more than I normally do at home but not to great excess. For instance, last night I had about a half of bottle of red wine at night with dinner and two beers with lunch. The alcohol at dinner was followed by haggling in a large shopping area and around a 4 mile brisk walk back to the cruise ship I am on where I experienced the palpitations, "on the walk that is to say". I did not go see the ship's doctor and rather emailed your service because the ship's doctor would have told me to go to the hospital here in Istanbul,being concerned about liability, and I would really like to wait until I get back home to see a cardiologist if the odds are I will be okay.
I will limit alcohol consumption for the remainder of the trip and hope not to have any recurrence, as consumption of wine seems to trigger this, "could sulfites in the wine be a factor as the two beers at lunch did not seem to trigger an episode?"
I plan on a EKG, 48hour holter monitor setup, and a stress test with a cardiologist wheni return. There has never been any shortness of breath associated with the symptoms. Hopefully, again, the symptoms will not return as they contribute to anxiety and seem to make themselves worse when I think about it. My wife was given .5 mg of Xanax, "alprazolam" for anxiety while flying. Would this help during an episode or should I not take anything without knowing the cause of my palpitations? It certainly has put a damper on my trip but such is the situation. Thank you for your reply.
Thank you for the detailed follow up.
It is a good sign that could get one entire night's rest.
The palpitations could have been triggered by the excessive alcohol content, and yes some recent studies do claim that in a very small percentage of people wine may cause missed beats, or palpitations, attributed to the sulfites. So in this scenario, it would be better for you to avoid alcohol.
I can also understand your anxiety regarding the issue,and anxiety itself can lead to further palpitations.
So try to avoid but if anxiety gets the better of you, then you can use Xanax.
Since you just finished a marathon, it is unlikely you have any heart disease and the 2D ECHO should be normal. So you can update me once you are back and have all your reports. Meanwhile try to avoid alcohol as far as possible.