Combo of colder temperatures and physical exertion increases the workload on the heart.

Each winter as Nebraska temperatures drop and heavy snow blankets the state, reports of weather-related heart incidents make news.

The American Heart Association says that for most people, shoveling snow may not lead to any health problems. However, the association warns that the risk of a heart attack during snow shoveling may increase for some, especially those in poor physical condition or those with existing heart disease or a personal history of stroke.

The combination of colder temperatures and physical activity increases the workload on the heart, according to the association. People outdoors in cold weather should avoid sudden exertion, like lifting a heavy shovel full of snow. Even walking through heavy, wet snow or snow drifts can strain a person’s heart.

For more information on how cold weather affects the heart, visit heart.org/coldweather.

To help make snow removal safer, the American Heart Association has compiled a list of practical tips.

• Give yourself a break. take frequent rest breaks during shoveling so you don’t overstress your heart. Pay attention to how your body feels during those breaks.

• Don’t eat a heavy meal prior or soon after shoveling. Eating a large meal can put an extra load on your heart.

• Use a small shovel or consider a snow thrower. the act of lifting heavy snow can raise blood pressure acutely during the lift. It is safer to lift smaller amounts more times, than to lug a few huge shovelfuls of snow. when possible, simply push the snow.

• Learn the heart attack warning signs and listen to your body, but remember this: Even if you’re not sure it’s a heart attack, have it checked out (tell a doctor about your symptoms). Minutes matter! Fast action can save lives–maybe your own. Don’t wait more than five minutes to call 9-1-1.

• Don’t drink alcoholic beverages before or immediately after shoveling. Alcohol may increase a person’s sensation of warmth and may cause them to underestimate the extra strain their body is under in the cold.

• Consult a doctor. If you have a medical condition, don’t exercise on a regular basis or are middle aged or older, meet with your doctor prior to exercising in cold weather.

• be aware of the dangers of hypothermia. Heart failure causes most deaths in hypothermia. To prevent hypothermia, dress in layers of warm clothing, which traps air between layers forming a protective insulation. Wear a hat because much of your body’s heat can be lost through your head.

• Learn CPR. Effective bystander CPR, provided immediately after sudden cardiac arrest, can double or triple a victim’s chance of survival. Hands-only CPR makes it easier than ever to save a life. If an adult suddenly collapses, call 9-1-1 and begin pushing hard and fast in the middle of the victim’s chest until help arrives.

Some heart attacks are sudden and intense–the “movie heart attack,” where no one doubts what’s happening. But most heart attacks start slowly, with mild pain or discomfort.

Often people affected aren’t sure what’s wrong and wait too long before getting help. Here are signs that can mean a heart attack is happening:

• Chest discomfort. Most heart attacks involve discomfort in the center of the chest that lasts more than a few minutes, or that goes away and comes back. It can feel like uncomfortable pressure, squeezing, fullness or pain.

• Discomfort in other areas of the upper body. Symptoms can include pain or discomfort in one or both arms, the back, neck, jaw or stomach.

• Shortness of breath with or without chest discomfort.

• Other signs may include breaking out in a cold sweat, nausea or lightheadedness.

As with men, women’s most common heart attack symptom is chest pain or discomfort. But women are somewhat more likely than men to experience some of the other common symptoms, particularly shortness of breath, nausea/vomiting, and back or jaw pain.

Calling 9-1-1 is almost always the fastest way to get lifesaving treatment. Emergency medical services (EMS) staff can begin treatment when they arrive–up to an hour sooner than if someone gets to the hospital by car.

EMS staff is also trained to revive someone whose heart has stopped. Patients with chest pain who arrive by ambulance usually receive faster treatment at the hospital, too.

It is best to call EMS for rapid transport to the emergency room. If a person can’t access EMS, they can have someone drive them to the hospital right away. Anyone having symptoms shouldn’t drive unless there is no other option.

For more information, visit a physician or call the American Heart Association at 800-AHA-USA1 or visit online at heart.org.