Of all the things that could ruin your holidays, suffering a heart attack would have to be near the top of the list.

Unfortunately, this is the time of year when people are most likely to have heart problems. Studies show that heart-attack deaths spike in December and January. There are several possible reasons for this, but doctors say nearly all of the triggering factors are preventable.

"It’s a combination of things," said Dr. Mitch Davis, a cardiologist at Northeast Georgia Heart Center in Gainesville. "People are too busy to exercise (during the holidays). They have more family stress. They consume too much alcohol. They’re not staying on a heart-healthy diet."

Davis said anyone who has existing heart disease or is even at risk for a cardiovascular problem needs to remain vigilant throughout the year. Because he knows the holidays can be a minefield, he works with his patients in advance to develop a coping strategy.

"I tell them to make smart food choices, maintain their exercise routine, limit alcohol to two drinks per day, and get their flu and pneumonia shots," he said.

Respiratory infections are more common in the winter, which Davis said contributes to the increase in heart attacks during this season.

"When a person has pneumonia or the flu, the oxygen level in their blood may drop, and that can cause a heart attack," he said.

Davis said patients should also try to avoid emotional stress, which he acknowledges may be almost impossible at Christmastime. Reluctant to give up on any holiday traditions, many people push themselves to the limit with shopping, gift-wrapping, baking, decorating, having parties and traveling to visit family.

If people insist on doing all these things, Davis advises that they at least pace themselves.

"Plan ahead so you don’t have to do all your holiday chores at once," he said.

And if you get drunk at the office Christmas party, there’s more to worry about than just making a fool out of yourself in front of your co-workers. At this time of year, it’s not unusual for someone to be rushed to the emergency room with "holiday heart," a condition that can be triggered by a drinking binge.

"Alcohol is a toxin to the heart," said Davis. "It can affect the heart’s electrical system and disrupt its rhythm, causing atrial fibrillation."

And all those cookies and sausage balls you ate at the party may do more than just expand your waistline.

"Most food at parties is not heart-healthy. It’s high in sodium and saturated fat," said Bobby Norris, coordinator for cardiopulmonary rehabilitation. "People may think they can just exercise more and burn off the calories. But too much rich food could have longer-term effects on things like cholesterol."

But Norris is not suggesting that exercise doesn’t matter.

"Exercise is extremely important for combating stress," he said. "For our patients who are diabetic, it also helps control blood sugar."

Norris said some people assume they don’t need to exercise during the holidays because they’re already active. But a shopping trip is not a substitute for a workout.

"They think they’ve had their full requirement of exercise because they’ve been shopping all day," he said. "But it’s not continuous aerobic activity, which is what your heart needs."

Norris conducts a rehabilitation class for Phase 2 heart patients, who have had a "cardiac event" such as a heart attack or bypass surgery within the past six weeks.

"Attendance drops this time of year because people say they’re too busy with family and other things," he said. "We tell them they need to incorporate exercise into whatever they’re doing, even if they can’t come to a formal exercise class."

However, many patients do slack off on their regimen in December, Norris said. Then comes New Year’s Day, with the familiar resolutions about getting in shape.

"They do come back in January," he said. "But if they’ve taken a whole month off, it’s like starting from scratch."

While people may view the holidays as a much-needed break from everyday life, Davis said the heart never takes a vacation. So Northeast Georgia Medical Center’s Ronnie Green Heart Center is always open for business.

Though Davis hopes people will take steps to prevent heart attacks, if you do experience chest pain on Christmas Eve, you shouldn’t have to worry that there won’t be a doctor available to treat you.

"We don’t cut back on staffing during holidays," said Davis, referring to his cardiology group. "We have a general cardiologist and an interventional cardiologist on call every night."

And just like people who work in retail, heart doctors know better than to expect they’ll have much leisure time in December.

"From what I’ve observed in my 11 years of practice, it does seem that we’re more busy in the winter," Davis said.