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Alcohol Induced Hangover: Causes, Prevention, and Treatment

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Alcohol induced hangovers are estimated to cost one hundred forty-eight billion dollars in related absenteeism and poor job performance in the United States annually as per Dr. Steven Reisman a Cardiologist in New York City. A hangover is the experience of unpleasant physiological and psychological effects after drinking too much alcohol. These symptoms usually begin when the blood alcohol level falls significantly and is at or near zero. Symptoms include headache, tremulousness, nausea, diarrhea, dry mouth, fatigue, anxiety and general discomfort. Those with an alcoholic hangover have diminished visual-spatial skill and dexterity.

Hangovers can last up to twenty-four hours. There appears to be several physiological processes occurring.  Alcohol or ethanol is broken down to acetaldehyde and this is thought to be ten to thirty times more toxic than alcohol. This process adversely affects certain bodily processes. These breakdown products may also increase susceptibility to oxidative stress in the body.  In addition, it is felt that certain alcoholic beverages that contain “congeners” as a flavoring or as the byproduct of fermentation may aggravate the hangover and its effect. Usually dark liquors have a higher concentration of congeners and clear liquors have a lower concentration. The clear liquors such as gin and vodka may have a lesser effect and cause a less severe hangover than the darker liquors.

The best prevention is to drink in moderation, for example, limiting drinks to one per hour. Certainly abstinence from the ingestion of alcohol is the BEST prevention. It is best to eat food before drinking and also important to drink slowly and not to drink too much at one time. One should drink a large quantity of water to stay hydrated. If one experiences a hangover, symptomatic treatment is recommended including drinking water to prevent dehydration, eating foods such as toast and crackers and bouillon soup, and rest or sleep if one is tired. If one ingests alcohol or experiences a hangover the individual should not drive an automobile or any other type of vehicle and should stay away from heavy machinery. According to Dr. Steven Reisman, a New York City Cardiologist and Director of The New York Cardiac Diagnostic Center the most effective way to avoid the symptoms of alcohol induced hangover is to avoid drinking alcohol.

 

 

 

Occurrence of Heart Attacks May Be Increased During the December Holiday Season According To Dr. Steven Reisman A New York City Cardiologist.

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Some studies have shown that there appears to be an increased incidence of heart attacks around the Christmas and New Year’s season according to Dr. Steven Reisman a Cardiologist in New York City. A heart attack occurs when there is an acute blockage of blood supply and thus oxygen supply in one of the arteries supplying the heart muscle resulting in the death of heart muscle tissue unless this blockage is rapidly opened up and reversed within a few hours of the onset of this symptom. A heart attack can be symptomatic with the development of symptoms such as chest pressure, jaw pain, indigestion like symptoms, shortness of breath, and can also have atypical symptoms such as left arm and back pain. A heart attack can also be without symptoms and then it is known as a “silent” heart attack.

During the holiday season the increase in occurrence of heart attacks is thought to happen because of several reasons. It is well known that cold weather such as strenuous snow shoveling can be a factor constricting blood vessels to the heart and increasing the clotting of blood. Heavy physical exertion can also be a factor in cold weather such as strenuous snow shoveling. In addition, vigorous snow skiing particularly in those who are not in excellent physical shape can also be a related to the increased occurrence of heart attacks. Since the holiday heart attack increase has also been seen in warmer climates, other factors may be at work including psychological factors and also people may delay seeking medical attention even with chest pain because they want to wait until they return home.

According to Dr. Steven Reisman, a Cardiologist in New York City and the Director of the New York Cardiac Diagnostic Center several preventative steps can be taken. Regular exercise is a very important factor especially before skiing or snow shoveling. In addition a heart healthy diet such as a mediterranean diet that includes fiber and omega 3 fatty acid foods is recommended. In particular, no sudden vigorous exercise should be undertaken if the individual is not in shape and one should also wear several layers of warm clothing in cold weather. The prevention of psychological factors such as anger, hostility, and depression is important. It is highly recommended that preventative testing and screening take place before undergoing vacation or vigorous exercise if one is unsure about one’s own risk for heart attack.

New York City Cardiologist Dr. Steven Reisman Explains The Relationship Between Binge Alcohol Drinking And The Holiday Heart Syndrome

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The holiday heart syndrome was described over thirty years ago according to Dr. Steven Reisman, a New York City Cardiologist. This entity which is important to keep in mind during the Christmas and New Year’s season occurs usually secondary to increased and frequently heavy alcohol consumption. It results in palpitations, a rapid heart rate and at times also an irregular heart rhythm.

This syndrome is usually experienced by an individual without prior evidence of heart disease. One might experience “heart pounding” or palpitations at a rapid heart rate and possibly irregularity of the heart beat. It is possible also to experience lightheadedness and in some instances an episode of fainting.

Several studies have related this symptom to moderate or heavy alcohol drinking and it frequently occurs after a weekend of holiday binge drinking. The cardiac evaluation usually results in finding a fast heart rhythm (frequently atrial fibrillation which is usually a rapid and irregular heart beat). Some studies found that in over thirty-five percent of new patients with atrial fibrillation in people less than sixty five years old the cause is heavy alcohol consumption. Frequently this syndrome resolves spontaneously if there is no prior history of atrial fibrillation or heart disease and with abstinence from further alcohol consumption.

Dr. Steven Reisman a New York City Cardiologist and Director of The New York Cardiac Diagnostic Center recommends against heavy alcohol binge drinking and if these symptoms should occur one should seek immediate medical attention.

Dr. Steven Reisman, a Cardiologist in New York City, Interviewed on Fox News about Obesity as a Disease.

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Is obesity a disease

Dr. Steven Reisman, a New York City cardiologist, was recently interviewed on Fox Business News regarding the American Medical Association recently passing a resolution recognizing obesity as a disease.  A disease, which is defined as an abnormal condition which interrupts normal bodily functions and is usually associated with symptoms and signs, may also include disorders and syndromes.

Obesity is generally defined as an elevated Body Mass Index (BMI). This is a formula utilizing both height and weight. A BMI over 30 is generally considered obese. One of the problems with using only the BMI is it may overestimate body fat in athletes and others with a  muscular build, and may also underestimate body fat in older persons and those who have lost muscle mass. Another way of defining obesity is looking at “belly fat” by measuring the waist circumference. It is thought that a waist size greater than 35 inches for women and greater than 40 inches for men increases the risks that are associated with obesity and overweight individuals.

It is estimated that 1 in 3 Americans are obese. The complications of obesity include high cholesterol and elevated triglycerides, Type 2 Diabetes, high blood pressure or hypertension, metabolic syndrome, which is a combination of high blood sugar, high blood pressure, and high lipids, and also heart disease including heart attack and stroke. One study has shown that obesity can increase the risk of dying from heart attacks by 60% compared to non-obese individuals.

Dr. Steven Reisman, Director of the New York Cardiac Diagnostic Center, recommends early evaluation for obesity and also early evaluation for the complications of obesity including elevated blood sugar or type 2 Diabetes, high blood pressure, elevated lipids, and the possibility of risk for heart attack and stroke. This type of evaluation can be accomplished in a consultation with testing done at the New York Cardiac Diagnostic Center.

Dr Steven Reisman, a New York City Cardiologist and Director of the New York Cardiac Diagnostic Center announces the implementation of a new device for the early detection of risk for heart attack and stroke

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Dr. Steven Reisman, a New York City Cardiologist and Director of The New York Cardiac Diagnostic Center announces the recent implementation in his office of a device to measure “endothelial dysfunction” which is a measurement useful in the early detection of risk for heart attack and stroke. The device is call EndoPat and it is a fifteen minute test  with the patient lying down and probes put on one finger in each hand to measure the ability of blood vessels to dilate after the inflation of a blood pressure cuff for several  minutes.

EndoPat measures reactive hyperemia. Reactive hyperemia is calculated automatically by the device and shows the degree of vascular reactivity. Several recent studies have shown an abnormal test reveals dysfunction which can be an early risk factor for the development of atherosclerosis and “hardening of the arteries” and may also be a contributor to the progression of atherosclerosis.

The measurement of endothelial dysfunction is important in the early determination of risk for atherosclerosis; endothelial dysfunction may even be present before the occurrence of obstructive blockages on other imaging modalities. It is known that the process of atherosclerosis begins early in life and endothelial dysfunction contributes to this disease state and in fact precedes the development of plaque in the blood vessels.

Thus the use of this device to measure endothelial dysfunction or flexibility verses stiffness of the blood vessel is important in individuals early on to identify those who need aggressive life style changes along with risk factor modification in the prevention of both heart attack and stroke. Many interventions such as exercise, weight reduction, a healthy diet, and occasionally medications have been demonstrated to be beneficial in improving endothelial function. EndoPat can also be used to follow the individual’s response to these interventions over time.

EndoPat has been shown to be useful in many groups of patients including those with a family history of coronary artery disease, individuals with chest pain, those with elevated levels of cholesterol or triglycerides, diabetics, those with hypertension, women with chest pain, and also men with erectile dysfunction.

Dr. Steven Reisman, Director of the New York Cardiac Diagnostic Center, recommends that EndoPat can also be used in younger and middle age individuals as an early indicator of the need for aggressive attention to life style modification in those who are at increased risk for heart attack and stroke.

THERE HAS BEEN AN INCREASING INCIDENCE OF STROKES IN YOUNG ADULTS AND MIDDLE AGED ADULTS ACCORDING TO CARDIOLOGIST DR. STEVEN REISMAN

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Several studies over the past several years have shown an increase in strokes among those age 20 to 54 years old according to Dr. Steven Reisman, Director of the New York Cardiac Diagnostic Center, and a Cardiologist in New York City.

A stroke occurs when blood flow to a part of the brain stops and there is a decrease in oxygen supply to the brain and brain cells die.  The symptoms of a stroke can occur suddenly and without any warning and the symptoms depend on which part of the brain is damaged. These symptoms can include a sudden headache, change in vision, muscle weakness on one side of the body, difficulty speaking, loss of balance and coordination and other neurologic symptoms.

The number one risk factor for stroke is high blood pressure or hypertension. The other risk factors includes diabetes mellitus, smoking, atrial fibrillation and high cholesterol.  In young adults and those in middle age another factor can also be a congenital small hole in the heart from birth called a patent foramen ovale (PFO).

In young patients frequently there is found one of these cause such as hypertension, smoking and a occasionally a PFO. In addition, the increasing incidence of stroke may partly be related to improved medical technology and the increased adoption of MRI as a diagnostic tool to identify strokes in young people.

This increasing incidence of stroke should serve as a warning for young adults and middle age individuals to improve their lifestyle and early diagnosis of risk factors.

Dr. Steven Reisman, a New York City Cardiologist and Director of the New York Cardiac Diagnostic Center advocates early diagnosis of risk factors for stroke including blood pressure evaluation, blood testing, and potentially echocardiography and carotid ultrasound in prevention.

Dr. Steven Reisman- a New York City cardiologist, shedding light on ‘mini stroke!’

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doctor studying MRI scan

Frankie Muniz, the star from the successful comedy series ‘Malcolm in the Middle’ has been in the news lately, however, not for his acting skills this time. Frankie who is aged just 27, suffered from a ‘mini stroke’, which is often looked upon as a sign for an upcoming stroke.

Well, shedding light on this serious heart condition, Dr. Steven Reisman, the Director of New York Cardiac Diagnostic Center, while talking to Inside Edition said, “A mini-stroke is temporary. The key word is temporary. It comes and it goes, usually within several hours. It’s really a warning sign. A full stroke is usually more permanent damage that can last, that can be severe or mild or moderate, and it doesn’t go away quickly.”

Talking to Inside Edition, Mr. Muniz, who was more than shocked at the situation that he had to face said, “I am still trying to make sense of it, but I am happy that I’m alive!”

Talking about it, Dr. Reisman further explained that in a mini-stroke, blood flow to a part of the brain stops for a brief period of time. He said the concerned person will have stroke like symptoms for a short time period that can be somewhere between 1-2 hours and up to 24 hours.

As the brain is affected in a mini-stroke, it is seen that a person usually may suffer from memory loss or confusion, as well as the ability to recognize objects or people and people can also have loss of balance and coordination after a stroke.

Although it is usually associated with people from higher age groups, the unhealthy lifestyle of younger adults has led to an increase in the incidence of mini-stroke amongst younger people as well.

ACUTE TRIGGERS FOR CARDIOVASCULAR EVENTS SUCH AS HEART ATTACK AND STROKE

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Dr. Steven Reisman, a New York City cardiologist, will discuss the relationship between acute risk factors or acute triggers and the development of a heart attack or stroke. It is well known that there are chronic risk factors for heart disease such as hypertension, hyperlipidemia, diabetes mellitus, smoking, and other factors. There are also acute risk factors that can precipitate a cardiac event. Acute risk factors may result in a rapid increase in blood pressure, vasoconstriction, or even increase in coagulability.

There are several psychological triggers that are known to play a role. These include anger, emotional upset, anxiety, stress in the work place, bereavement, and sexual activity.

An interesting phenomenon has been observed that showed a significant increase in heart attacks at 9 am in the morning. It appears that the act of waking up, when a person who is vulnerable to a heart attack, goes from a supine to an upright position increases the catecholamines in the body. These particular individuals most likely have an underlying plaque that is vulnerable and is more likely to clot in the morning.

There are physical triggers that can include vigorous physical activity along with sexual activity. These factors play a bigger role in those who are sedentary and a lesser role in those who have the habit of exercising on a regular basis.

There are psychological stresses which include an outburst of anger which elevates the risk of heart attack. Also, episodes of anxiety can increase the risk of a heart attack. In addition, depression and frustration may also be associated with increasing the risk of a heart attack.

There are also population stresses that can increase the risk of a heart attack such as earthquakes, war, and even elevated pollution levels and respiratory infection and also floods.

Dr. Steven Reisman, a New York City cardiologist and director of the New York Cardiac Diagnostic Center feels that an initial evaluation with a cardiologist in consultation to evaluate risk of a heart attack along with proper exercise and treatment of psychological stress and prevention of psychological stress is key to helping diminish the risk of heart attack and stroke in these individuals.

DR. STEVEN REISMAN, A CARDIOLOGIST IN NEW YORK CITY, DISCUSSES THE RELATIONSHIP BETWEEN PRE-DIABETES, TYPE 2 DIABETES AND METABOLIC SYNDROME

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The prevalence of type 2 diabetes is increasing in the United States according to Dr. Steven Reisman, Director of the New York Cardiac Diagnostic Center and a cardiologist in New York City. Pre-diabetes is usually defined as an elevation of fasting or post-prandial glucose levels. The American Diabetes Association has defined impaired fasting glucose as a level of 100 to 125 mg/dl. Also, an elevation in hemoglobin A1c or glycosylated hemoglobin (HbA1c) at a level of 5.7% to 6.4% may also represent pre-diabetes.

 

Metabolic Syndrome is related to pre-diabetes. Metabolic Syndrome is defined as any three of the following five components. These components include an elevated glucose level, abdominal obesity, elevated blood pressure, elevated triglycerides, and reduced high-density lipoprotein (HDL) cholesterol. Most individuals with metabolic syndrome have abdominal obesity. It is felt that insulin resistance may be mediating the metabolic risk factors of the metabolic syndrome. Most people with metabolic syndrome have insulin-resistance. It should be noted that the prevalence of pre-diabetes and metabolic syndrome overlap but not exactly. One can consider the metabolic syndrome as a pre-diabetic state. When comparing individuals without metabolic syndrome, those with this syndrome have an approximate 5-fold increase in diabetes risk. Once pre-diabetes is combined with metabolic syndrome, the risk is increased even more for diabetes.

 

The major adverse outcomes in individuals with pre-diabetes are macrovascular disease and type 2 diabetes, the leading contributors to microvascular disease. Macrovascular disease occurs both before and after the onset of diabetes, whereas microvascular disease occurs predominately several years after becoming diabetic. Metabolic Syndrome is a risk factor for macrovascular disease. Initial management is lifestyle intervention including weight reduction in obese subjects, reduced intake of dietary saturated and trans-fatty acids, cholesterol, and sodium along with increased physical activity.

 

According to Dr. Steven Reisman the Director of the New York Cardiac Diagnostic Center and a cardiologist in New York City these initial steps of lifestyle intervention in first line management should be emphasized to this group of individuals along with a thorough assessment of cardiovascular risk.

DR. STEVEN REISMAN, A CARDIOLOGIST IN NEW YORK CITY, DISCUSSES THE EFFECT OF DIETARY PROTEIN AND CONTENT ON WEIGHT GAIN DURING OVEREATING

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According to Dr. Steven Reisman, one of the best cardiologists in New York City and the Director of the New York Cardiac Diagnostic Center, obesity and overweight affect greater than 60% of the United States public. It is estimated that the United States government spends in excess of $200 billion per year on obesity associated conditions and diseases.

Obesity is the result of an accumulation of excess body fat. Obesity is not just excess body weight because overweight can occur from either muscle or fat deposition. Diet composition can affect the relationship between total body fat and body weight. Obesity related medical conditions may be associated with an accumulation of excess fat while increased muscle mass is beneficial because of its positive effect on metabolism.

There is a large body of scientific evidence that indicates that protein is the most satisfying of the macronutrients. High protein diets providing 25% of total energy compared to diets with low protein may lead to greater weight loss. Reduced total caloric intake with an increase in the intake of low-fat protein-rich foods may result in more successful weight loss in the long term secondary to the effects on resting energy expenditure.

It is possible that patients who exercise and eat adequate protein may build lean body mass more efficiently than those who are on a low protein diet. Because muscle weighs more than fat per unit of volume it is possible for patients to gain weight with muscle mass while reducing weight circumference and overall fat.

In addition to a healthy long term diet, it is important to increase the proportion of omega-3 fats, increase the intake of colorful fruits and vegetables, and limit the intake of refined carbohydrates from soft drinks, cookies, cakes, pastries, candies, and many processed foods with both hidden fat and sugar. In addition, physical activity is important along with behavioral interventions including self-monitoring stimulus control, stress reduction, and social support that may be helpful in weight loss.

Clinicians should consider evaluating a patient’s overall fatness rather than simply by measuring body weight or body mass index and concentrate on the potential complications of excessive fat accumulation. The goals for treatment of obesity should involve fat reduction rather than simply weight loss, along with a better understanding of nutrition.

Dr. Steven Reisman director of New York Cardiac Diagnostic Center and a leading cardiologist in New York City advocates and promotes a healthy lifestyle in the prevention of heart disease and the reduction of obesity.

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