Around the state, cities have accumulated up to 7 inches or more of snow since Sunday.

If you are headed out to shovel a path out of your home, whether that be today or tomorrow, the American Heart Association encourages people to protect their hearts while shoveling. Shovelers should seek immediate treatment if they experience any signs or symptoms of a heart attack, the AHA says.

Research shows that many people may face an increased risk of a heart attack or sudden cardiac arrest after shoveling heavy snow.

“Shoveling snow can be a very vigorous activity, and you’re basically doing it in a freezer,” says Dr. William Gill, a cardiologist who is president of the American Heart Association board of directors in Indianapolis. “Those conditions can very quickly lead to stress on the heart.”

Here’s how to stay safe while shoveling and how to identify the signs of a heart attack.

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To help make snow removal safer, the American Heart Association suggests:

• Give yourself a break. Take frequent rest breaks during shoveling so you don’t overstress your heart. Pay attention to how your body feels during those breaks.
• Don’t eat a heavy meal prior or soon after shoveling. Eating a large meal can put an extra load on your heart.
• Use a small shovel or consider a snow thrower. The act of lifting heavy snow can raise blood pressure acutely during the lift. It is safer to lift smaller amounts more times, than to lug a few huge shovelfuls of snow. When possible, simply push the snow.
• Learn the heart attack warning signs and listen to your body, but remember this: Even if you’re not sure it’s a heart attack, have it checked out (tell a doctor about your symptoms). Minutes matter! Fast action can save lives — maybe your own. Don’t wait more than five minutes to call 9-1-1
• Don’t drink alcoholic beverages before or immediately after shoveling. Alcohol may increase a person’s sensation of warmth and may cause them to underestimate the extra strain their body is under in the cold.
• Consult a doctor. If you have a medical condition, don’t exercise on a regular basis or are middle aged or older, meet with your doctor prior to the first anticipated snowfall.
• Be aware of the dangers of hypothermia. Heart failure causes most deaths in hypothermia. To prevent hypothermia, dress in layers of warm clothing, which traps air between layers forming a protective insulation. Wear a hat because much of your body’s heat can be lost through your head.

The American Heart Association urges people to learn the signs of a heart attack so they can recognize the signs and to call 9-1-1 immediately if they experience any of those signs.

Some heart attacks are sudden and intense like they are shown as in movies and tv shows. This is what the American Heart Association calls a “movie heart attack,” where no one doubts what’s happening.

In reality, most heart attacks start slowly, with mild pain or discomfort. Often people affected aren’t sure what’s wrong and wait too long before getting help.

Here are signs that can mean a heart attack is happening:

• Chest discomfort. Most heart attacks involve discomfort in the center of the chest that lasts more than a few minutes, or that goes away and comes back. It can feel like uncomfortable pressure, squeezing, fullness or pain.
• Discomfort in other areas of the upper body. Symptoms can include pain or discomfort in one or both arms, the back, neck, jaw or stomach.
• Shortness of breath with or without chest discomfort.
• Other signs may include breaking out in a cold sweat, nausea or lightheadedness.

As with men, women’s most common heart attack symptom is chest pain or discomfort. But women are somewhat more likely than men to experience some of the other common symptoms, particularly shortness of breath, nausea/vomiting, and back or jaw pain.

Calling 9-1-1 is almost always the fastest way to get lifesaving treatment. Emergency medical services (EMS) staff can begin treatment when they arrive — up to an hour sooner than if someone gets to the hospital by car. EMS staff is also trained to revive someone whose heart has stopped. Patients with chest pain who arrive by ambulance usually receive faster treatment at the hospital, too. It is best to call EMS for rapid transport to the emergency room. If you can’t access EMS, have someone drive you to the hospital right away.

“I can’t stress enough the urgency of getting proper treatment for a heart attack,” Dr. Gill says. “Don’t die of doubt. If you’re experiencing symptoms or something just doesn’t feel right, go get it checked out. Hospitals offer life-saving treatment.”

Katie Wiseman is a trending news reporter at IndyStar. Contact her at klwiseman@gannett.com. Follow her on Twitter @itskatiewiseman or Bluesky @katiewiseman