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This winter season will bring cooler temperatures and ice and snow for some. For most people, shoveling snow may not lead to any health problems. It’s important to know how cold weather can affect your heart, especially if you have cardiovascular disease. People who are outdoors in cold weather should avoid sudden exertion, like lifting a heavy shovel full of snow. Even walking through heavy, wet snow or snow drifts can strain a person's heart.

How does cold weather affect the heart?
Many people aren't conditioned to the physical stress of outdoor activities and don't know the dangers of being outdoors in cold weather. Winter sports enthusiasts who don't take certain precautions can suffer accidental hypothermia.

Hypothermia means the body temperature has fallen below 95 degrees Fahrenheit. It occurs when your body can't produce enough energy to keep the internal body temperature warm enough. It can kill you. Heart failure causes most deaths in hypothermia. Symptoms include lack of coordination, mental confusion, slowed reactions, shivering and sleepiness.

Children, the elderly and those with heart disease are at special risk. As people age, their ability to maintain a normal internal body temperature often decreases. Because elderly people seem to be relatively insensitive to moderately cold conditions, they can suffer hypothermia without knowing they're in danger.

People with coronary heart disease often suffer angina pectoris (chest pain or discomfort) when they're in cold weather. Some studies suggest that harsh winter weather may increase a person's risk of heart attack due to overexertion.

Besides cold temperatures, high winds, snow and rain also can steal body heat. Wind is especially dangerous, because it removes the layer of heated air from around your body. At 30 degrees Fahrenheit in a 30-mile wind, the cooling effect is equal to 15 degrees Fahrenheit. Similarly, dampness causes the body to lose heat faster than it would at the same temperature in drier conditions.

To keep warm, wear layers of clothing. This traps air between layers, forming a protective insulation. Also, wear a hat or head scarf. Heat can be lost through your head. And ears are especially prone to frostbite. Keep your hands and feet warm, too, as they tend to lose heat rapidly.

Don't drink alcoholic beverages before going outdoors or when outside. Alcohol gives an initial feeling of warmth, because blood vessels in the skin expand. Heat is then drawn away from the body's vital organs.

To help make snow removal safer, here is a list of practical tips.

Give yourself a break. Take frequent rest breaks during shoveling so you don’t overstress your heart. Pay attention to how your body feels during those breaks.
Don’t eat a heavy meal prior or soon after shoveling. Eating a large meal can put an extra load on your heart.
Use a small shovel or consider a snow thrower. The act of lifting heavy snow can raise blood pressure acutely during the lift. It is safer to lift smaller amounts more times, than to lug a few huge shovelfuls of snow. When possible, simply push the snow.
Learn the heart attack warning signs and listen to your body, but remember this: Even if you’re not sure it’s a heart attack, have it checked out (tell a doctor about your symptoms). Minutes matter! Fast action can save lives — maybe your own. Don’t wait more than five minutes to call 9-1-1
Don’t drink alcoholic beverages before or immediately after shoveling. Alcohol may increase a person’s sensation of warmth and may cause them to underestimate the extra strain their body is under in the cold.
Consult a doctor. If you have a medical condition, don’t exercise on a regular basis or are middle aged or older, meet with your doctor prior to exercising in cold weather.
Be aware of the dangers of hypothermia. Heart failure causes most deaths in hypothermia. To prevent hypothermia, dress in layers of warm clothing, which traps air between layers forming a protective insulation. Wear a hat because much of your body’s heat can be lost through your head.
Learn CPR. Effective bystander CPR, provided immediately after sudden cardiac arrest, can double or triple a victim’s chance of survival. Hands-only CPR makes it easier than ever to save a life. If an adult suddenly collapses, call 9-1-1 and begin pushing hard and fast in the middle of the victim’s chest until help arrives.