With frigid weather moving in, the rush to clear away heavy, slushy snow is on.
But doctors say clearing a sidewalk or driveway is not worth risking your health, if the job is too big or requires too much exertion.
Intense, heavy lifting can be hard on the heart and cold air makes the situation worse, University of Minnesota cardiologist Greg Helmer said.
"It restricts coronary arteries and blood vessel supply, so the colder it is the more important probably to put something over your face, or a facemask, to prevent that further aggravating the heart condition," he said.
Helmer said people with prior heart disease should probably avoid shoveling snow. They are at the greatest risk of having a heart attack from the activity. Smokers and people who have a family history of heart problems also have an elevated risk.
But he said moderate shoveling can be good exercise for people who are in good health.
Nevertheless, physicians are reminding people to take breaks and avoid excess exertion when removing snow from sidewalks and driveways.
Although someone with prior heart disease is at the greatest risk of having a heart attack caused by shoveling, it can happen to anyone, Minneapolis Heart Institute cardiologist Tom Knickelbine said.
"My grandfather was not a heart patient and he actually had a fatal heart attack shoveling in his 60s, so you don't have to be a heart patient," Knickelbine said. "But if you already have heart disease, this combination is really a little bit of asking for trouble."
Smokers and people who have a family history of heart problems also have a higher risk of heart attack brought on by shoveling.
Knickelbine recommends that people in elevated risk groups use a self-propelled snow blower when possible, or have someone else shovel for them.