Shoveling snow can trigger a heart attack. As many as 1,200 heart-related deaths occur yearly during and after major snowstorms, one study estimated.
Shoveling is strenuous exercise and, with the extreme cold weather it can increase blood pressure, push the heart rate up and increase a protein called fibrinogen that promotes blood clotting. All of these factors contribute to increase the risk of a heart attack.
Who is most at risk? Sedentary adults -- particularly men over age 45 and women over 55 who aren't used to strenous exercise. Also at risk are smokers, and people with any combination of high blood pressure, high cholesterol, or diabetes.
To minimize the danger of snow shoveling:
Warm up first with stretching or movement to get the body accustomed to vigorous exercise in the cold.
Wear appropriate clothing so layers can be removed to avoid overheating.
Take breaks, and pay attention to how your body feels during those breaks. If you're tired, stop shoveling.
Shovel with a smaller rather than a larger shovel -- lifting less weight will put less strain on your heart.
If you experience symptoms like chest pain or upper body pain that doesn't go away or keeps coming back, call 911.
WABC-TV in New York City prepared this report.