Shoveling, especially snow shoveling in the cold, can trigger heart attacks because it suddenly forces your heart to work much harder in conditions that already strain your arteries and blood pressure.
What happens to your heart
- Shoveling heavy snow is intense exercise, often comparable to peak effort on a treadmill stress test, which rapidly raises heart rate and blood pressure.
- If someone has narrowed coronary arteries from plaque (often without knowing it), this surge in demand can exceed the blood and oxygen supply to the heart muscle, triggering a heart attack or dangerous rhythm problem.
Why cold weather makes it worse
- Cold temperatures cause blood vessels to constrict and blood pressure to rise, so the heart must pump harder even before lifting a shovel.
- Cold also reduces blood flow to the heart muscle and can make blood more likely to clot, further increasing the chance that a partially blocked artery becomes fully blocked.
Specific stresses of shoveling
- Shoveling uses mostly the arms and upper body while the legs stay relatively still, which is more taxing on the heart than leg-focused exercise and can cause blood to pool in the legs, reducing blood return to the heart.
- People often strain, lift heavy, wet snow, and hold their breath while pushing or lifting (a Valsalva maneuver), which spikes blood pressure and adds sudden load on the heart.
Who is at highest risk
- Those with known heart disease, prior heart attack, angina, high blood pressure, diabetes, smoking history, high cholesterol, obesity, or who are sedentary are at highest risk from shoveling.
- Middle‑aged and older adults, especially men over about 45–55 who are not regularly active, show a clear increase in heart attack and sudden cardiac death around heavy snowfalls.
How to lower the risk
- People with heart disease or multiple risk factors should strongly consider avoiding shoveling altogether and using help or a snow blower instead.
- For those who do shovel: dress warmly, push rather than lift when possible, take frequent breaks, avoid very heavy or wet snow loads, do not smoke before shoveling, and stop immediately for chest pressure, shortness of breath, or pain in arm, neck, jaw, or back and seek emergency care.
