As Americans living on the Eastern seaboard break out the snow shovels, doctors are telling them to take special care, and have "great respect" for the dangers of blizzard conditions, both during and after the storm.
Doctors say slips and falls are the most common injuries caused by snow and ice seen in the ER, but they also warn of heart dangers that may come with a snowfall.
"The risk of heart attack is increased by the combination of heavy, upper body exertion and cold weather encountered while shoveling snow," said Dr. William Abraham, director of the division of cardiovascular medicine at Ohio State University. "People, especially those at risk for coronary heart disease, should avoid heavy exertion in cold weather conditions."
That's because people can be unaware of their own heart blockages, and even an insignificant heart condition can suddenly become significant in certain weather, said Dr. Randy Zusman, director of the Massachusetts General Hospital Heart Center.
There are two major points that can put people at risk for heart problems when it's cold.
"For one, most people don't realize that, when their hands get cold, it causes blood vessels in the heart to constrict and reduce the blood supply to their heart," said Zusman. "I always tell people to invest in the best pair of gloves they can afford and remember to be all buttoned up before going outside."
So, if a blood vessel is 20 percent to 30 percent blocked, it can become up to 70 percent to 80 percent blocked due to the constricting walls in the cold weather conditions, said Zusman.
And once the shovel comes out of the garage, things can often get much worse.
"People like shoveling snow. They complain about it, but they're devoted to that snow shoveling," said Zusman.
And with that devotion can come two things: raised blood pressure and an accelerated heart rate.
"Lifting heavy snow is like heavy weight lifting," said Zusman. "It puts a strain on the heart, and the blood pressure and heart rate go up in response to it."
And if those levels increase too much in a person who has a pre-existing heart condition, it can lead to angina or even a heart attack.
Because of this, Zusman said that people with any sort of heart conditions should avoid shoveling all together.
"I can be rather unbending on this issue," Zusman continued.
And for those with healthy hearts, Adelman said to be ready for the winter exertion by staying in shape throughout the year. "That way, when a physical demand is placed on a person [like shoveling], they are ready to react," said Adelman. "People should dress very warmly when going outside so as not to expend energy keeping warm. … And if they notice that they are getting out of breath, they should slow their pace and rest."
Dr. Gabriel Wilson, associate medical director at St. Luke's-Roosevelt Hospital in New York, worked his emergency room shift until 3 a.m. Monday. He cared for three people who'd sustained wrist fractures, one person with an ankle fracture and two who had received blows to the head. Every injury stemmed from slips on ice and snow.