(NewsNation Now) — A winter storm impacting the nation’s Central, Northern and Southern regions carries a different risk — heart attacks.

Reports estimate that hundreds of people die each year in the U.S. from a heart attack, either during or immediately after snow removal, according to the American Heart Association.

This is partially because many people who shovel snow rarely exercise, according to Harvard Medical School. After several months of inactivity, the resistance of tossing shovels-full of snow or pushing a heavy blower can strain the heart.

One 2020 study from the American Heart Association study found that after only two minutes of snow shoveling, participants’ heart rates exceeded 85% of maximal heart rate. That’s a similar level of exertion that’s usually prescribed for aerobic exercise studies, according to the American Heart Association.

Cold weather exacerbates that strain. Low temperatures can elevate blood pressure and increase the likelihood of forming blood clots, according to Harvard Medical School.

So-called “heart attack snow” is usually a reference to dense, wet accumulation, but the sheer amount of snowfall in some areas during Wednesday’s winter storm could present a similar challenge, National Weather Service Meteorologist Jake Petr said.

“We always encourage people to take frequent breaks if they’re out there shoveling snow. And those not shoveling but out traveling — make sure to check road conditions,” Petr said. “If you have to be out, take it slow and it’s always a good idea to have an emergency car kit.”

Silver Cross Hospital in New Lenox, Illinois recommends taking these safety measures:

• Do a little bit at a time, with ample breaks
• Dress appropriately. Ensure your hands are covered, wear layers and keep your feet dry and warm
• Listen to your body.  If you feel tired or sluggish, it’s time for a hot cocoa break
• If you, a loved one or neighbor begins to show signs of a heart attack, call 911 and seek medical attention immediately

Harvard additionally recommends warming up your muscles before shoveling or snow blowing and staying hydrated.

People also should head indoors at the first sign of chest pain, lightheadedness, shortness of breath or a racing heart.

“Any sudden onset of pain that radiates through your arm or neck accompanied with difficulty breathing or chest pain is a classic sign of a potentially fatal cardiac event,” Silver Cross Emergency Room Physician Dr. Aaron Tabor said in a news release.

Other signs of a heart attack can include pain or discomfort in the arms, shoulders, jaw, neck or back, according to the Centers for Disease Control and Prevention. Women are more likely to experience symptoms such as indigestion, heartburn, nausea or vomiting, and extreme fatigue, according to the CDC.