Shoveling Snow, Heart Attack, and Stroke: 3 Heart Doctors Share Their Insights on Staying Safe
Winter snow, heart attack, and stroke risk
Waking up after a snowstorm has a way of striking awe: how graceful the trees’ branches look beneath that coat of white; how, if even for just a short period, the world seems to slow down to a hush.
But when it’s time to clear your path and get out the door, that peaceful reflection should turn to a crucial focus: your safety. Shoveling snow can be extremely dangerous—a 2011 study by the Center for Injury Research and Policy of the Research Institute at Nationwide Children’s Hospital suggested shoveling snow led to 11,500 hospital admissions per year, seven percent of which were cardiac-related. While lower-back injuries from shoveling were the most frequent, shoveling-related cardiovascular events accounted for half of the hospitalizations and 100 percent of the fatalities over the study’s 17-year span.
And while you might already be aware that shoving can lead to heart attack, this cold-weather activity also increases the risk of stroke. “A stroke occurs when the brain does not receive adequate blood flow or oxygen delivery,” says Dr. Lance Richards, a cardiologist at UCHealth in Fort Collins, CO, who adds: “There is evidence supporting an increased incidence of stroke in colder temperatures or when temperatures change quickly. This is thought to be caused by vasoconstriction, or ‘clamping down,’ of the arteries when [your body is] exposed to cold.” Richards says this “can limit blood flow as well as raise blood pressure, a risk factor for stroke. Additionally, cold temperatures may increase the risk of clot formation due to thickening of the blood.”
Illustrating this, a study published in Environment International found, to put the researchers’ conclusion very simply: the colder the temperature, the greater odds of stroke. Additionally, a German study published in the European Journal of Epidemiology concluded for every 37°F drop in temperature over a 24-hour period, stroke incidence increased by 11 percent.
So before you head outdoors for that heavy lifting, arm yourself with cardiologists’ wisdom on how you can manage your risk of stroke and heart attack when the view outside says it’s time to shovel. (Their tips might make you want to come back here and read The 4 Best Exercises to Strengthen Bones in Your Upper Body, From an Exercise Physiologist).
Shoveling snow is strenuous
Shoveling snow is physically taxing even if you’re in good shape. For those at high risk for heart disease, shoveling snow can be especially dangerous because of the strain it puts on the heart. “In the cold weather, your smaller arteries, particularly in your feet and arms, have a tendency to constrict, and it creates a lot of back pressure on the heart,” says Shoeb Sitafalwalla, MD, a cardiologist at the Advocate Heart Institute at Advocate Lutheran General Hospital in Park Ridge, Illinois, reiterating some of Dr. Richards’ understanding. “This, combined with the fact that you’re lifting or shoveling heavy amounts of snow, increases the heart rate and oxygen demand on the heart.”
If you have a pre-existing heart condition, you risk taxing your heart to a level that it simply can’t handle, Dr. Sitafalwalla says. If you have coronary artery disease, heart failure, congestive heart failure, a weakened heart muscle, or tight or leaky valves that impede blood flow to the heart, it’s best to avoid shoveling snow altogether. Find out the 15 life-saving tips to prevent heart disease.
Don’t eat a big meal before shoveling snow
Your gut will demand more blood to digest food, so you have less available for your heart. “This adds more strain to an already strained system,” Dr. Sitafalwalla says.
Don’t shovel when you’ve been drinking, either: People may think the alcohol will warm them up, but the liquor constricts the blood vessels, creating more back pressure on the heart. (Also read These Are the Best Alcohol-Free Sparkling Wines—I Know Because I Tried Them All.)
Stay in shape year-round
Stephen Kopecky, MD, at the Mayo Clinic in Rochester, Minnesota, advises getting in shape a few months prior to when you anticipate having to shovel snow. As physically taxing shoveling snow can be, those who exercise often and don’t have any pre-existing heart conditions can usually complete the task without major problems.
For those who are inactive, Dr. Kopecky says they have a 70 to 80 percent higher risk of having a heart attack while shoveling that those who are active on a regular basis. Here are 15 other interesting things that happen to your body in the winter.
Do a warm-up
Make sure you do a dynamic warm-up before shoveling snow. And stretch after shoveling to avoid back spasms and injuries (check out 6 Stretches for Lower Back Pain). Back injuries are common, especially when shoveling heavy and wet snow, so a quick warm-up can help your body prepare for the strenuous task ahead.
Dr. Kopecky recommends squats, toe touches, and stretching your arms and legs. Additionally, Dr. Sitafalwalla says proper footwear with a firm grip is essential to help reduce falls on slippery driveways. (Peek at the 9 Best Winter Boots For Your Feet, According To Podiatrists.)
If a major snowstorm is in the forecast, make sure to shovel a few times throughout the storm (if it’s safe out there!) instead of waiting until it’s over. Shoveling or blowing smaller amounts of snow more frequently is less taxing than shoveling heavier and wetter snow all at once.
Remember: Push the snow across the driveway and don’t lift it, says Dr. Kopecky, since lifting the snow raises blood pressure (and also is considerably harder). If your blood pressure is high, consider these natural remedies that may help.
What to do if you feel discomfort
“If you feel discomfort—chest pain, chest tightness, and shortness of breath—stop shoveling,” Dr. Kopecky says. If the discomfort does not go away within five minutes, and you have medications for a pre-existing heart condition, take your pills. Also try finding someone to sit with until symptoms dissipate, so you’re not alone if something happens. Dr. Kopecky advises individuals to go to the emergency room if discomfort persists for 20 minutes after shoveling. (Here’s why a heart attack is more likely in the winter.)
Consider getting someone to clear the snow for you
As you age, seek the help of a younger neighbor or a snow-removal service when it comes time to shovel snow. “If you have a heart condition, feel free to stimulate your local economy and get some people around you to take care of it,” says Dr. Sitafalwalla. Just make sure you know them personally or they’ve worked for someone you know—it’s safer than allowing a a stranger to poke around your garage or ask to use your bathroom.
Know the warning signs of heart disease
There are several general warning signs of heart disease. If you notice any of the following, it’s important to consult a physician and avoid shoveling snow:
1) Chest pain, which can also be described as a chest pressure, burning, or discomfort, which occurs upon exertion and calms down at rest;
2) “Chest discomfort can often radiate to the arms, the neck, the back, and even the jaw, so that should be paid attention to as well,” says Dr. Sitafalwalla;
3) Severe or unusual shortness of breath is another warning sign of heart disease;
4) High blood pressure, high cholesterol, and diabetes are also risk factors for pre-existing heart disease.
Some women may experience all the above symptoms, but some may also feel none of them. For those who don’t experience any telling symptoms, Dr. Sitafalwalla says to be aware if the person expresses a vague sense of anxiety, severe fatigue, or discomfort near their chest or heart. (Here are 7 silent signs of a heart attack.)
To help prevent stroke while you shovel, follow these tips:
- Stop immediately if you experience any symptoms. These include weakness in the arms or legs, drooping of the face, and trouble speaking. If you experience any of these, stop immediately and call 911. (Many stroke response specialists advise not to have a loved one drive you to the emergency department. Calling 911 enables the paramedic team to administer stroke-response protocol as soon as they arrive. As stroke experts say, minutes matter: your chance of being permanently affected by stroke increases with every moment that passes. Call an ambulance to get care as soon as possible.)
- Talk to your doctor before engaging in any strenuous outdoor activity in winter temperatures. This is especially important if you have pre-existing conditions like cardiovascular disease, diabetes, or high blood pressure. “I recommend discussing the safety of partaking in physical outdoor activities in the winter with your physician prior to starting,” says Dr. Richards. “If you are someone with pre-existing conditions, it may be wise to have a family member, neighbor, or local kid take care of outdoor work such as snow shoveling.”
- Dress warmly. Your heart has to work harder when your body is cold, increasing arterial pressure in the brain and the risk of stroke. So bundle up!
- Remain active year round. The more physically active you are, the better your cardiovascular and brain health will be, thereby reducing your risk of stroke.
- Warm up first. Before you rush outside to shovel, move your body: get your blood flowing, stretch, and drink some water.
- Stay hydrated. Dehydration reduces blood volume, increasing risk of stroke.
- Don’t overdo it. Avoid straining yourself by shoveling smaller amounts of snow at a time or using a snowblower if there’s a lot of snow. Also, take breaks when you experience fatigue.
For daily wellness news you need, get The Healthy newsletter. We’ve got more:
- The American Journal of Emergency Medicine: "Snow shovel-related injuries and medical emergencies treated in US EDs, 1990 to 2006."
- Shoeb Sitafalwalla, MD, cardiologist at the Advocate Heart Institute at Advocate Lutheran General Hospital in Park Ridge, Illinois
- Stephen Kopecky, MD, professor of medicine at Mayo Clinic in Rochester, Minnesota
- Harvard Medical School: "Calories burned in 30 minutes for people of three different weights
- Lance Richards, DO, FACC: Cardiologist at UCHealth Heart and Vascular Clinic.
- Medical Science Monitor: “The Effect of Winter Temperature on Patients with Ischemic Stroke”
- Environment International: “Effects of cold temperature and snowfall on stroke mortality: A case-crossover analysis”
- American Heart Association: “Chilling studies show cold weather could increase stroke risk”
- European Journal of Epidemiology: “Rapid weather changes are associated with increased ischemic stroke risk: a case-crossover study”