Snow shoveling and cardiac risk 

A new fall of snow marks the start of the "snow shoveling season", part of the folklore of Emergency and Cardiology Departments across the world. 

A recent paper from Watson et al (Am J Emerg Med 2011; 29: 11–17) indicates this is more than just folklore and that when predominantly sedentary people suddenly undertake vigorous activity in cold weather a whole range of medical problems occur.

Interestingly, the vast majority are soft tissue injuries, particularly involving the back. However, 6.7% are new onset cardiovascular events and these were even more common in the over-55s. The study relied on data entry via the National Electronic Injury Surveillance System and there was no attempt to look at whether the onset of snow leads to a rise in incidence of cardiovascular events. Nor was there information available to determine whether any particular individuals in the over-55 age group were more at risk. However, there was outcome data and use of a snow shovel accounted for an estimated 1647 cardiovascular deaths between 1990 and 2006.

Good reason to be alert to the potential cardiovascular risks posed by the "snow shoveling season"!