It was Christmas 2010. Like many others, Julie Rickman, then 41, was preparing for the busy holidays: shopping, baking, and attending celebrations with families and friends.

Rickman also did something else that is more common at Christmas time than other times of the year. She had a heart attack.

CHEERFUL HEART: Rickman saved her heart by taking caution and going to the hospital. Others aren't so lucky, as winter increases the likelihood of a heart attack. Photos: Courtesy of the American Heart Association

Increased risk

Death from heart attacks peaks during the winter holidays. According to a 2004 study in Circulation, a journal of the American Heart Association, Christmas and New Year’s are considered risk factors for cardiac death.

Researchers don’t know exactly why heart attacks are more common around the holidays, but possible reasons include changes in diet, stress, respiratory problems and not paying attention to the symptoms of a heart attack: chest pain, shortness of breath, neck, arm or jaw pain, nausea, lightheadedness and cold sweat.

Catching the red flag

“We were running around everywhere, and I couldn’t catch my breath,” Rickman recalls. The day after Christmas, Rickman got winded while folding laundry. She thought it was exhaustion but decided to go to the emergency room, anyway.

Now 47, the Overland Park, Kansas resident realizes that trip saved her life. Along with blockages in her heart, doctors discovered that earlier in December Rickman had a heart attack.

“I have no idea when the heart attack happened,” she admits. “I attributed feeling badly to the holidays and thinking I was exhausted.”

CARDIAC DE-STRESS: In addition to factors like weather and diet which affect the likelihood of a heart attack, Rickman works to ensure that her stress levels are controlled, doing her best to remain healthy and relaxed.

Silent killers

The process leading to a heart attack begins long before the event, says Jorge Plutzky, M.D., a volunteer with the American Heart Association and director of preventive cardiology and cardiovascular medicine at Brigham and Women's Hospital in Boston, MA. “Factors like cold weather, stress and dietary indiscretion can trigger an event in someone at risk for a heart attack because a person’s blood pressure is higher or their heart is working harder,” Plutzky says.

Rickman, an American Heart Association volunteer, has since changed her approach to the holidays. “The biggest challenge is controlling stress,” Rickman says. “I don’t try to do it all. I have my list, but it’s not a list of unrealistic expectations.”

“People who have already had a heart attack are at even higher risk during the holidays,” Plutzky adds. “Make sure the holidays don’t get in the way of taking your medicines, going to cardiac rehab and doctor’s visits, and continuing to be attentive to a healthy lifestyle.”