In Buffalo or Missoula, a 20-inch snowfall might get a half-hearted shrug. But when that much snow fell on Charlottesville, Va., the night of Dec. 19, 2009, it was a record-setting storm that forced folks to do something they weren't used to doing — shovel snow. That doubled the number of people having heart attacks usually seen each day at the University of Virginia Medical Center. Two-thirds of the attacks were the result of blood clots that formed in or around stents that had been placed months before to open a narrowed coronary artery (American Journal of Cardiology, August 2010).

Snow shoveling is a known trigger for heart attacks. Why? Many people who shovel snow rarely exercise. Picking up a shovel and moving hundreds of pounds of wet snow, particularly after doing nothing physical for several months, can put a big strain on the heart. Cold weather is another contributor because it can boost blood pressure, interrupt blood flow to part of the heart, and increase the tendency for blood clots to form.

The best way to prepare for shoveling is by exercising regularly throughout the year. That way your muscles and heart are ready for action.

Here is some advice on safe shoveling we have given before. It may be especially appropriate for anyone who has had an artery-opening stent placed in the last few months:

  • Warm up your muscles before starting.

  • Shovel many light loads instead of fewer heavy ones.

  • Take frequent breaks.

  • Drink plenty of water.

  • Don't feel that you need to clear every speck of snow from your property.

If you are out of shape or worried about your heart, hire a teenage neighbor. He or she could use the money, and probably the exercise.