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The Common Winter Chore That Can Trigger a Heart Attack  

Unless you’re in great shape, it’s probably best to let someone else shovel the sidewalk

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’Tis the season for snowstorms, freezing rain and chilling winds in many areas of the country. But if you’re an older adult, you should think twice before digging yourself out of winter’s wrath, health experts say, especially if you have a heart condition or a history of heart disease. The same advice applies to individuals who aren’t used to regular exercise.

Every year people die of a heart attack during or just after snow removal, says Barry A. Franklin, who has studied the effects of snow shoveling on the heart and is the lead author of an American Heart Association scientific statement on exercise-related heart risks.

In fact, nearly 200,000 people were treated in emergency rooms for snow-shoveling-related incidents from 1990 to 2006, according to a 2011 study published in The American Journal of Emergency Medicine. That’s an average of 11,500 people a year. About 1,647 deaths were also recorded during that time — all cardiac related. 

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“The movements of snow shoveling are very taxing and demanding on your body and can cause significant increases in your heart rate and blood pressure,” Franklin says. “Combined with the fact that the exposure to cold air can constrict blood vessels throughout the body, you’re asking your heart to do a lot more work in conditions that are diminishing the heart’s ability to function at its best.”

Franklin’s team found that the exertion required to shovel snow drives up a person’s heart rate and blood pressure. In addition, since the chore requires engaging seldom-used arm muscles while the legs are mostly still, blood tends to pool in the lower extremities. At the same time, cold temperatures constrict the arteries, decreasing the amount of blood and oxygen reaching the heart.

Straining and breath-holding — common when lifting heavy loads, like wet snow — further aggravate the stress on the heart.

“It really is a perfect storm for a heart attack,” says Franklin, who is director of preventive cardiology and cardiac rehabilitation at Beaumont Health in Royal Oak, Michigan. “It’s physically very, very taxing.” 

Danger depends on fitness level, risk factors

A 2017 study published in the Canadian Medical Association Journal examined 128,073 hospital admissions and found that heavy snowfall was associated with a higher risk of hospital admission for heart attacks in men. The risks were elevated regardless of age, cardiovascular risk factors and other health conditions.

Franklin advises anyone age 45 or older not to tackle shoveling. He says the recommendation stems from a landmark study that indicates about 85 percent of U.S. adults age 50-plus already have underlying coronary artery disease. 

“We often see events in people who are usually sedentary, they work at a computer all day or get little or no exercise. Then once or twice a year they go out and try to shovel the driveway after a heavy snowfall and that unexpected exertion can unfortunately lead to tragedy,” he says.

6 Warning Signs of a Heart Attack

  • Chest discomfort — pressure, squeezing, fullness or pain — that lasts more than a few minutes
  • Pain or discomfort in one or both arms, back, neck, jaw or stomach
  • Shortness of breath
  • Nausea
  • Feeling weak, lightheaded or unusually tired
  • Breaking out in a cold sweat

If you experience any of these symptoms, call 911 immediately. Your chances of recovery and survival are better with quick treatment.

Source: American Heart Association and CDC

Experts say your level of risk largely depends on your fitness level and whether you have cardiovascular risk factors, such as a history of cardiac or vascular disease, obesity, smoking, high blood pressure, high cholesterol, diabetes or another chronic condition.

Anyone with those risk factors should avoid snow shoveling, health experts say. (About 60 percent of U.S. adults have at least one chronic disease, according to the Centers for Disease Control and Prevention; that number shoots up to over 85 percent when looking at data for people 65 and older.)

“Age alone shouldn’t be the only criteria,” says Jim Powers, M.D., a geriatrician at Vanderbilt University Medical Center in Nashville. “If you are a regular jogger, maybe you’re 65 and you’re retired and you’re jogging with no chest pain, you’re probably OK to shovel snow.”

Abdulla A. Damluji, M.D., a cardiologist at Inova Health System and an associate professor at Johns Hopkins University School of Medicine, agrees: “If you are an older adult who is fit — you exercise daily and you perform at high physical activity levels — shoveling snow is less risky.”


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If you are normally sedentary, on the other hand, shoveling snow could trigger a heart attack, even if you have no cardiovascular risk factors.

“It can be quite a shock to your system,” Franklin says. He notes that sudden cardiac death is the first, last and only symptom of underlying coronary disease about 25 percent of the time.

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8 tips to shovel snow safely

If you’re determined to clear your driveway, experts and the National Safety Council recommend taking the following steps to lower your risk.

1. Use a snowblower

Franklin’s research team found that healthy young men shoveling snow had an average heart rate of 170 beats a minute, compared with 120 beats per minute when they used a snowblower. “There’s no question that snowblowers reduce demands on the heart,” he says.

2. Do not shovel immediately after eating 

Digestion requires additional blood flow, which competes with the added blood flow needed for the physical demands of shoveling, Franklin explains. Also, avoid alcohol, anything with a lot of caffeine, smoking and marijuana before shoveling, as those substances are known to increase heart rate and blood pressure. 

3. Push, don’t lift 

Use your shovel to push snow to the side of the driveway or walkway, instead of trying to lift it.

4. Lift smaller loads

Use a small shovel, or only partially fill a larger one. The average weight of a shovelful of wet snow is about 16 pounds, Franklin says.

5. Protect your back

Bend at your knees and lift with your legs, not your back. A shovel with an angled, ergonomic handle will require you to exert less energy, Powers says.

6. Dress appropriately

Wear a hat, gloves and something over your mouth and nose, to warm the air before you breathe it in, Franklin suggests. Chilly air can trigger shortness of breath.

7. Take it slow

Start gradually. Do not work to the point of exhaustion. Take frequent breaks.  

8. Call 911 if you experience signs of a heart attack.

Call 911 immediately if you experience any of the following heart attack symptoms while shoveling snow: chest discomfort or pressure; shortness of breath; lightheadedness or nausea; breaking out in a cold sweat; discomfort in one or both arms, the back, neck, jaw or stomach.  

Franklin says he recommends — only somewhat jokingly — that people cut out and attach this label to their shovels: WARNING: Use of this instrument for snow removal may be hazardous to your health!

Editor's Note: This story, originally published Jan. 26, 2022, has been updated.

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