By Paul Goldfinger, MD, FACC
When I was working as a cardiologist, we were wary of snow storms because we knew that we would have to go to the ER to see shovelers who developed chest pains, dizziness, fainting, palpitations and other worrisome symptoms. But we also knew that the fatalities were usually among those who simply died without any warning—due to a major cardiac rhythm disturbance.
The early signs of a heart attack are well known, although sometimes they can be misleading. For example, chest pains may be harmless, due to muscle strain from shoveling. On the other side of the coin, the early signs of a heart problem might be ignored, such as when jaw or arm pain occur without chest discomfort or if you become short of breath.
If you are having symptoms but are unsure, the best bet is to go to the ER. I could tell you how to analyze your symptoms, but for a lay person: “Better to be safe than sorry.”
If you are thinking about shoveling, there is an important principle that you should know: silent coronary heart disease (ie without any warnings) is common, and you might be at risk of dying during shoveling even though your doctor says you are healthy and even though you feel fine. This is true even if you had a negative stress test.
Cardiologists refer to “hearts too good to die.” That means that heart disease, where arteries on the surface of the heart develop blockages severe enough to cause sudden death, may be associated with a strong heart, and that the narrowed arteries could have been fixed if diagnosed.
The risk of sudden death during shoveling is particularly relevant for those who have risk factors: over age 50—especially males, smokers, high cholesterol, family history of early heart disease, high blood pressure, diabetes, sedentary, obese, and known heart disease. Even those under age 50 might be at risk from shoveling if they have major risk factors such as family history.
The best advice: don’t shovel snow. Let some kid do it. It’s cheaper than having your family pay for a funeral.
This may sound harsh, but I have seen it. I personally know someone who died suddenly in his 50’s while snow shoveling and without a cardiac history. He was a heavy smoker with very high cholesterol. I know two doctors without known heart disease who died suddenly while cross country skiing. So don’t be foolish.
If you do shovel, do not do so after a meal or after having caffeine or nicotine. Pace yourself and rest frequently. Remember that the stress on your cardiovascular system during strenuous exercise will be especially extreme in cold weather, even if you dress warmly and think that you are protected . The cold air causes your arteries to constrict and your blood pressure and heart rate to shoot up abruptly. Cover your face.
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This article re-posted as needed. —-PG
CLARENCE “FROGMAN” HENRY says take care of yourself—it’s a gift to your loved ones.
The snow has to get shoveled by someone, so please heed this good advice and be safe out there with the pending storm!
Reblogged this on Blogfinger and commented:
We first posted this article four years ago, but it is still relevant.
As a cardiac nurse who did many rotations in the E.R., I can second all that.
One more suggestion … don’t load the shovel to the point of straining. Keep it light.