FORT WAYNE, Ind. (WANE) — As parts of the middle of the country prepare for this weekend’s big snowfall, doctors want to remind everyone to protect their heart while shoveling the snow.

While doctors say, in most cases, shoveling snow isn’t an activity that directly causes someone to have a heart attack, it can cause symptoms.

“Snow shoveling is tremendous work,” said Dr. Mark O’Shaughnessy, a cardiologist at Parkview Hospital Randallia. “So, if a person has artery disease and they’re doing that shoveling, they’re increasing their work on their heart, and they can have chest pain, angina.”

On top of the physical activity, shovelers are outside in cold weather, so their bodies are also working to stay warm.

“It’s kind of a double whammy on the heart,” said O’Shaughnessy. “You’re doing the physical exercise, but it’s hard to also try and work hard to maintain your body temperature so that extra work can cause symptoms in patients.”

Symptoms to be aware of include shortness of breath, undue fatigue, and chest heaviness, or pressure that spreads to other parts of the body such as the left arm or left jaw.

“If you’re having symptoms, you [need to] stop the activity, don’t try to force yourself through,” said Dr. O’Shaughnessy. “You need to stop and let somebody else do that and call your primary care physician.”

Dr. O’Shaughnessy said shovelers should also be cautious about catching frostbite, injuring their backs or slipping.

To avoid this, he suggests dressing warm and if possible wearing shoes with spikes.

The American Heart Association also offered the following suggestions to make the snow removal process safer:

• Take frequent breaks so you don’t overstress your heart.
• Don’t eat a heavy meal prior to or soon after shoveling.
• Use a small smaller shovel so you’re not lifting as much.
• Don’t drink alcohol before or immediately after shoveling.