Why, how and how often do heart attacks happen shovelling snow?
I don’t know what it is about the winter season, but there always seems to be more talk of persons in accidents or having health issues. Part of it is the ice causing falls and the temperature keeping people indoors. One of the things that we see in our physiotherapy clinic, is stories of having heart attacks after shoveling snow.
Our bodies response to heat or cold
One of our body’s main priorities is to keep our heart protected. It does this by making sure your chest and abdomen stay at the right temperature. This is where all of your vital organs. If it is too hot, your body needs to push heat away from your center. It does this by expanding the arteries around your heart and pushing it to your arms and legs. You also start to sweat.
When it is cold out, you essentially get the opposite reaction. To keep your center warm, it makes the arteries around your heart smaller. This causes more blood to stay near the chest. It’s also why your hands and feet get cold first. This is called vasoconstriction.
Why the risk?
When you are out shoveling in the snow, you are out in the cold and therefore you have that natural vasoconstriction happening. This is a normal body response. The extra piece to this puzzle is that you are exercising. When you are outside shoveling, it really is high-intensity exercise.
High-intensity exercise causes us to breathe heavier, sweat more, our body temperature goes up. It also causes an increase in blood pressure and heart rate.
So far all of this is normal.
For some however, the combination of higher blood pressure, increased heart rate and smaller vessels size can create the perfect storm for a heart attack. The combination of the three can cause a blockage of one of the arteries near the heart. This leads to a heart attack.
What are the risk factors?
There hasn’t been a lot of research done in this area. But from the little that has been done, people who have heart attacks are usually already at some kind of cardiovascular, or heart, risk.
A heart attack is not normally a sudden event but rather a condition that has developing over time. So here are the risk factors
• Not exercising, or being sedentary
• Male gender (sorry guys but this also might be because more men than women are the snow shoveler’s in the family!)
• A family history of premature heart issues
• You’re taking medications for high blood pressure or high cholesterol or both.
If your body isn’t used to exercising, especially heavy duty exercise, it can be a shock to your system! You need to train your body to handle all of life’s tasks. Unfortunately for us here in Canada, snow shoveling included!
Do you have these risk factors? It isn’t meant to scare you but acts more as a precaution. Starting to exercise will make your body more resilient and therefore you become more able to handle the task of shoveling snow.
Even using a snow blower can be a big task because you have to move a fairly heavy piece of equipment. If you are worried about a loved one, paying someone else to do the snow shoveling might be an option. Just be careful, as an anecdotal aside, getting rid of the snow is a way that people are able to get out of the house and be independent. Having to wait for someone else to get out of your house could be very frustrating. I think about how important it is for my loved ones to be able to leave their house when they want to.
Asking a physiotherapist to help you get onto an exercise program to increase your endurance and strength could help!
We did an FAQ video on some tips to keep you safe shovelling (not just your heart but you back too!). Check it out here!
Janardhanan, R., Henry, Z., Hur, D. J., Lin, C. M., Lopez, D., Reagan, P. M., . . . Keeley, E. C. (2010). The snow-shoveler’s ST elevation myocardial infarction. The American Journal of Cardiology, 106(4), 596-600. doi:10.1016/j.amjcard.2010.03.075 [doi]
Nichols, R. B., McIntyre, W. F., Chan, S., Scogstad-Stubbs, D., Hopman, W. M., & Baranchuk, A. (2012). Snow-shoveling and the risk of acute coronary syndromes. Clinical Research in Cardiology : Official Journal of the German Cardiac Society, 101(1), 11-15. doi:10.1007/s00392-011-0356-6 [doi]