Dear Dr. Garner,

I am writing this to help other people avoid the tragic Christmas my family had last year. My husband, who was in good health, had “indigestion” last Christmas Eve. He was 66 years old and never really had any medical problems.

He took some Mylanta we had in the refrigerator, and felt a little better. He was having a great time, and didn’t want to leave the party. The pains worsened a little and we called an ambulance. Before it arrived, he passed away.

If we had only taken him to the hospital right away, I believe he would still be here today.

Please print this story, so others may be spared our tragedy.

Sad Widow in Williamsburg

Dear Sad,

Unfortunately, your story is not a rare one. I was just talking about this situation with my good friends and loyal Tablet readers from Howard Beach, Anne and Dick Gutzmann.

The most number of heart attacks occur between Thanksgiving and Christmas. In addition, they tend to be the most deadly.

The Christmas season is a time when we do things to our body that increase our risk for heart attacks.

Some of these factors are:

Medications - It is common for people to forget to take their medications during this period. With all the excitement, and travel, people lose their medications, forget to take them, or simply don’t refill their prescriptions on time. Depending upon the medications missed, there may be an increased risk for heart problems.

Stress - “Tis the Season” for stress, whether shopping or preparing for parties, we all experience extra stress. Unfortunately, stress is a leading cause of heart attacks. When we experience stress, the blood vessels that supply our heart become narrowed and don’t transport as much blood to the heart. Combining this situation with extra exertion, such as in shoveling snow in cold weather, or just carrying heavy packages, also predisposes someone to increased risk of heart attacks.

Fat Consumption - this is the time we tend to eat fatty meals. After a fatty meal, there is an increased likelihood for the blood vessels to develop clots. These can lead to an obstruction in the arteries supplying a heart, which is what we know as a heart attack. The risk of increased heart attacks occurs for about six hours after a fatty meal.

Alcohol - Part of the revelry in this Christmas season involves the use of alcohol. When used in moderation, there is usually no problem, and in fact, may be beneficial to our overall health. Unfortunately, when overdone, it can be deadly. Binge drinking (having more than five drinks) often occurs, and can cause the heart to develop a fatal irregular heart beat. In fact, a syndrome has been named after this, known in the medical field as “Holiday Heart.” With this irregular beat, there are not only increased risks for heart attacks, but also for strokes. The large amount of alcohol imbibed actually irritates the heart and causes the irregular rhythm.

Exercise - Unfortunately, this time of the year is very difficult to exercise. There are just too many things going on. We tend to put on weight and this puts extra stress on the heart. If we could just walk 30 minutes a day, five days a week, we could actually avoid many of the problems brought about by our eating at the various parties.

Salt - The recommended amount of salt (sodium) we should intake each day is 2400 milligrams. For many of the holiday foods, we exceed this with one portion. The salt causes fluid retention and puts stress on our heart.

Denial - The most deadly factor to deal with is denial. People at celebrations feel their pain is due to indigestion. They don’t want to ruin a good time they are having at the party, and tend to ignore symptoms, much like your late husband.

Knowing that there is increased risk of heart attacks this time of year, how can we recognize when we need to get to the emergency room?

The symptoms are very different for men and women.

• For women, the classic sign of chest pain that men experience is often not present. Gasping for air, and holding one’s chest, is not usually what happens if you are female. For women, the most common symptoms are severe fatigue, depression, indigestion, nausea, pale color and sweating. Chest pain may occur, but in a majority of cases, it may not be the main symptom.

• For men, symptoms are usually described as “someone is sitting on my chest” or “I have crushing chest pain, going down my left arm.” Men also feel nauseous, and sweat and look pale. Indigestion and vomiting may occur. When asked to show where the pain is, they tend to rub their palm across the chest instead of pointing to a single spot with one finger.

The bottom line about symptoms however, is that heart attacks can present with many different pains and signs. There is no set way to tell if you are having a heart attack, without being examined and having blood tests drawn.

The good news is that if one gets to the emergency room right away, doctors can actually reverse the effects of a heart attack, by cleaning out the blockage.

I urge all our readers not to hesitate if you think you are having a heart attack. No one will be upset at the hospital, if you come for a suspected heart attack and it turns out to be indigestion.

It may be deadly if you postpone the visit. Don’t hesitate to call the ambulance. Many people are saved on the way to the hospital and this is the best and safest way to get there.

I wish you peace and thank you for helping me to get the word out to our readers about your tragedy and hopefully we can prevent this tragedy from happening to another family this Christmas.

I hope you all have a great week, and till next week, stay well.

Dr. Steven Garner, MD, is a Fidelis Care provider who is affiliated with New York Methodist Hospital, Park Slope. He also is the host of the popular cable TV call-in show, “Ask the Doctor,” seen locally on The Prayer Channel.