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Q: How does cold weather affect your heart?

A: Being in cold temperatures can constrict blood vessels and ramp up heart rate and blood pressure, according to Dr. Issam Moussa, the medical director at Carle's Heart and Vascular Institute.

When blood vessels become constricted, most of the blood volume gets trapped in the core of the body, which, in turn, makes the heart work harder, Moussa said.

"Cold is like doing a really hard stress test," he said.

Add to that a typically sedentary lifestyle, picking up a snow shovel and going to work on the driveway, "and you kind of stress yourself out even more," he said.

If you're in good heart health, cold weather isn't likely to boost your chances for a heart attack, Moussa said.

The trouble is, many people have blockages in their arteries and don't know it until they have a heart episode, he said.

Experts advise heading into winter knowing your risks for heart disease, and two of those risk factors are simply being older and/or having a family history of heart disease. Some of the common — and controllable — risk factors are also being overweight, smoking, too much alcohol, an unhealthy diet and physical inactivity.

If you are at risk for heart disease and must do your own snow shoveling, here is some advice from Moussa to be on the safer side:

Bundle up. When you're out in the cold, you shouldn't be shivering, which is an alarm sign. If you're shivering, either go back indoors and dress more warmly, or stop shoveling.

Don't go out and shovel snow all at once, say, for a half-hour at a time. Shovel for a few minutes, then go back inside and warm up before you start again. (That's even if you've gotten by with shoveling the whole driveway at once before.)

If you begin having breathing difficulty or a feeling of pressure on the chest, don't ever ignore it. Put the shovel down and seek medical attention. "The most common reason people don't come in time to the hospital is denial," Moussa said.

If chest discomfort and difficulty breathing begins after exertion, it's likely related to the workout you just had. After increasing stress on your heart, it can take five to 10 minutes for symptoms of a heart episode to appear.

Cold weather discomfort in the chest area isn't always a sign of heart trouble, Moussa also said. Cold weather can also irritate the airways, sometimes causing coughing. How you know it's not just an irritation of the airways is if you're feeling chest pain or as though someone is sitting on your chest, he said.