Chicago - As Chicago and much of the Midwest receives its first major snowfall of the season, experts at Northwestern's Bluhm Cardiovascular Instituteare urging people with known heart disease to take caution when removing snow. “Shoveling snow is a very strenuous physical activity that puts a high degree of stress on the heart and its circulation,” says Charles Davidson, MDmedical director of the Cardiac Catheterization Laboratory at Northwestern Memorial Hospital and Associate Director of Northwestern’s Bluhm Cardiovascular Institute. “It has a profound effect on both the heart rate and blood pressure. In people with risk factors for heart disease, this activity may be putting them at risk for very serious heart problems including heart attacks.”

Patients need to understand their risk for heart disease prior to undertaking snow shoveling. Well-known risk factors for heart disease include smoking, over the age of 50, diabetes, hypertension, elevated cholesterol, and a family history of heart disease. Being relatively inactive or obese are also factors that may further add to their risk of heart disease. If your doctor has given you clearance, here are some precautions to remember:

Bundle up: Cold temperatures reduce circulation to the body’s extremities. Wearing weather-appropriate, layered clothing and gloves will help maintain body temperature and circulation.

Start early: Snow is easier to shovel when it first falls. The longer snow sits on the ground, it compacts which makes it heavier. Removing compacted snow requires more exertion, placing stress on the heart.

Ease into it: As with any physical activity or cardio exercise, the body must warm up. Ease into shoveling and try not to do the entire job at once.

Remain hydrated: The body needs hydration, even in cold weather. When shoveling snow, take frequent breaks and drink water regularly to prevent dehydration.

Avoid heavy eating: Eating a small meal before shoveling will provide a source of energy. However, digestion puts strain on the heart, so eating a large meal before any physical activity should be avoided. Additionally, alcohol and caffeine should also be avoided just prior to shoveling.

Don’t pick up too much: Large loads of snow can be heavy and place strain on the heart, back and neck. Push, instead of lift and use a small shovel, which encourages smaller loads of snow.

Listen to your body: Experts say the best indicator of whether or not snow shoveling is causing harm is to pay close attention to the body’s signals. If you begin to feel winded or overexerted while shoveling, take a break. These are signs that you’re doing more than your body can handle. If you experience shortness of breath, chest, throat or arm discomfort or tightness, or lightheadedness, you should rest and seek medical attention if the symptoms persist.

For more tips on managing heart disease, visit Northwestern's Bluhm Cardiovascular Institute.