Heart attacks while shoveling snow are a well-documented risk. Men with underlying heart disease, high blood pressure, diabetes or low fitness are especially vulnerable.

The American Heart Association says exertion from shoveling snow, especially in cold weather, can increase the risk of a heart attack. Cold constricts blood vessels, raises blood pressure and can stress the heart when combined with strenuous activity.

A scientific review published in the Canadian Medical Association Journal found that heavy snowstorms correlate with a 16% higher risk of heart attacks and a 34% higher risk of heart attack-related deaths in men. Women had a much lower risk elevation — 1% and 4%, respectively.

The National Safety Council says snow shoveling leads to thousands of injuries and as many as 100 deaths nationwide each year. The NSC recommends taking it slow, using a smaller shovel, pushing snow rather than lifting it, and calling 911 if heart attack symptoms occur.