Alcohol Chest Pain

Alcohol Chest Pain

Authored by Pin Ng PhD

Edited by Hugh Soames

Reviewed by Michael Por, MD

Alcohol Chest Pain

Most people will be familiar with after-effects of alcohol. Whether it was one too many on a night out that no-one wanted to end, or a perhaps a little excess at a celebration, the hangover is so well-known in our culture that even non-drinkers can name the symptoms: headache, dehydration, light-sensitivity.

But what if chest pain was added to that list?

What is alcohol chest pain?

The phenomenon is common enough that it is sometimes called ‘holiday heart syndrome’. The name is derived from the increase in presentations to doctors and hospitals by patients who, after an excess of alcohol over a holiday period, are now experiencing worrying chest pains1

And this is backed up by research. The British Medical Journal has published findings showing that the Sunday night to Monday morning period is the most common time for deaths from heart conditions. The consequence of the increased drinking that takes place on Friday and Saturday nights, and sometimes during the day, at weekends.

While there are many possible causes of chest pain, and medical advice should always be sought, alcohol can be the cause, and the pain is a sign that it might be time to radically reduce alcohol consumption, or even abstain altogether.

Isn’t alcohol good for the heart?

Many studies suggesting that alcohol can have beneficial health effects have been published, and these frequently get significant media coverage. These studies have found that alcohol might have direct and indirect benefits for heart health. For example, the antioxidant resveratrol in red wine can help lower blood pressure and cholesterol, while small amounts of alcohol have been suggested to improve mental health, which can, in turn, have physical health benefits.

However, there were a number of other factors that didn’t quite make the headlines, which will have contributed to the findings. The most important was that the studies only found the effects with moderate consumption, often less than a small glass of wine a day or its equivalent. Research has repeatedly shown that any benefits from alcohol are more than reversed by excessive consumption. Additionally, most of the research was conducted on people who had generally healthy lifestyles, in other words, the beneficial effects were reliant, and may even have resulted from, other factors like a balanced diet and regular exercise.

What causes alcohol chest pain?

There are several ways that alcohol might be linked to heart pain. Only a clinical professional can diagnose which it might be, or whether there is another cause, which is why it’s important to seek medical advice if chest pain is experienced.

Alcohol cardiomyopathy is perhaps the most serious potential cause of alcohol chest pain2 Cardiomyopathy is a heart disease, and its symptoms include chest pain. The disease causes the heart to enlarge, while the muscle walls become thinner, making the heart weaker and less effective.

Alcohol cardiomyopathy is most common in men, usually between the ages of 35 and 50 with a long-term history of excessive drinking. However, cardiomyopathy can have other causes, and in these cases, alcohol can worsen the condition and result in chest pain, even with moderate consumption and no history of alcohol abuse.

The mental health effects of alcohol can also, sometimes, cause chest pain. Alcohol is a depressant, and is linked with increased anxiety, especially when abused or following heavy drinking. In extreme cases, this can present as a panic attack the following day when the body attempts to rebound from the effects of excess alcohol. This can cause physical symptoms, including chest pain, that can be severe and is sometimes mistaken for a heart attack.

Alcohol can also cause other problems that result in chest pain. Alcohol can be an irritant, causing problems throughout the digestive tract, especially the esophagus and stomach. The combination of being acidic and acting as a relaxant on the esophageal sphincter can cause acid reflux in some people, which some will experience as a more general chest pain. Alcohol can also irritate the stomach lining, especially when abused, which can, again, cause a pain that some will experience as chest pain.

Finally, completely unrelated issues might be the cause of chest pain. There is a close link between alcohol and accidents that result in hospital admissions. It is not unknown for an unremembered accident from a drinking session to result in seemingly unexplained pain later.

What to do if you experience alcohol chest pain

It is important that if any chest pain is experienced, medical attention is sought immediately. While there are many potential causes of chest pain, only a professional can determine whether or not they are serious and require medical intervention. It is also worth being aware of the common symptoms of a heart attack, regardless of the cause, being able to recognize them can help save someone’s life.

The best-known symptom of a heart attack is a severe chest pain, in which the chest might feel like it’s tight or being crushed. This pain can radiate, spreading to the shoulders and arms, the back, and up into the jaw. It’s also likely that there might be difficulty breathing.

Less severe symptoms will include sweating, dizziness, nausea, and anxiety. There may also be a sense of impending doom, that can present before any other symptoms. While people can feel silly presenting to a doctor with a strong feeling something bad is about to happen, medical professionals recognize that, in otherwise mentally healthy people, this strong sense can actually be a symptom of a potentially life-threatening condition. Indeed, there are many documented cases where it has resulted in life-saving interventions.

Even if the pain feels mild, a medical examination is essential. And if the pain is associated with drinking, predictably occurring during or after drinking sessions, it is important to moderate, and ideally, stop alcohol consumption until the cause can be established and any necessary medical intervention can take place.

Alcohol has a definite role in cardiac arrhythmia, either by chronic abuse or by binge drinking. It is important to recognize holiday heart syndrome and be aware of the role of alcohol cardiac pathologies.

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References: Alcohol Chest Pain

  1. National Institute on Alcohol Abuse and Alcoholism [Cited in 2012 Sep 5]. Available from:
  2. Gorelick PB. Alcohol chest pain and stroke. Stroke. 1987;18(1):268–271. [PubMed] []
  3. Koskinen P, Kupari M, Leinonen H, Luomanmäki K. Alcohol and new onset atrial fibrillation: a case-control study of a current series. BrHeart J. 1987;57(5):468–473. [PMC free article]
  4. Mäki T, Toivonen L, Koskinen P, Näveri H, Härkönen M, Leinonen H. Effect of ethanol drinking, hangover, and exercise on adrenergic activity and heart rate variability in patients with a history of alcohol-induced atrial fibrillation. Am J Cardiol. 1998;82(3):317–322. [PubMed
  5. Liang Y, Mente A, Yusuf S, Gao P, Sleight P, Zhu J, et al. ONTARGET and TRANSCEND Investigators Alcohol consumption and the risk of incident atrial fibrillation among people with cardiovascular disease. CMAJ. 2012;184(16):E857–E866. []
  6. Shen J, Johnson VM, Sullivan LM, Jacques PF, Magnani JW, Lubitz SA, et al. Dietary factors and incident atrial fibrillation: the Framingham Heart Study. Am J Clin Nutr. 2011;93(2):261–266. []
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