Shoveling snow is essentially a Canadian pastime during those white winter months, but for some people, it can be more dangerous than they might think.

Dr. Al Qahwash, director of the cardiac program and critical care at St. Mary's General Hospital and Grand River Hospital in Kitchener, warns people that they shouldn't just grab the shovel and get to work without preparing a little bit.

Qahwash spoke with CBC Kitchener-Waterloo about the risks of shovelling heavy snow and some tips to avoid a trip to the emergency department.

Al Qahwash: Each snowfall we see more patients presenting with chest pain or heart attack in our emergency departments. We wouldn't throw on a pair of runners and tackle a 10K without training. After the snow settles on our driveways and sidewalks, we grab a shovel and we head out and do strenuous, repetitive exercise in the cold. Your heart rate increases, your blood pressure rises, blood vessels might constrict.

In the end, we're really setting ourselves up for heart attack, sprains, strains and other health implications. But snow doesn't have to spell doom and gloom. There are steps each of us can take to kind of help ourselves and our loved ones stay healthy and strong all winter.

A few suggestions: first, stretch. Don't bundle up, grab your tool of choice and jump to it. Take a moment to stretch your arms, chest and back before digging in shifts, taking small sections and rests in between.

By shoveling in shifts, you reduce stress on your heart, muscles and joints. While using smaller shovels may seem counterintuitive, it helps ensure you have the stamina to complete the job. Smaller, lighter loads help further reduce strain and help improve stamina.

And another thing I think we all know is to stop smoking. By now we know the health impacts of smoking and vaping. Stopping smoking significantly improves heart health and circulation. And lastly, know the signs of a heart attack: chest tightness, lightheadedness and dizziness. If you suspect any of these for you or for a loved one, please please call 911.

Qahwash: For sure, take breaks. Those signs are indications that you're probably heading in a bad direction. You want to take those precautions. Taking breaks is the most important thing because it is a strenuous activity.

Qahwash: Yes, 100 per cent. It's two things, primarily chest pain, which can be indicative of a possible heart attack, and then back sprains and strains. That's a big one.

Heart attacks are serious, of course, but back strains are the kind of things that stick around, too. They're there for the rest of your life sometimes.

Qahwash: Cardiovascular disease is a killer in this country. There's age, blood pressure, cholesterol, weight, stress and family history of heart attacks combined to really increase your risks of exercise-induced heart attack.

Like it or not, shovelling is an exercise. So there's a lot that we can do to keep our hearts healthy and prevent heart disease. You know, moderate exercise, healthy eating, reducing stress and maintaining a healthy weight can really help improve our heart health.

At St. Mary's General Hospital, we have a program that's powered by Manulife. It's called the PREVENT Clinic. And what we do is we see unattached patients that don't have a family physician that present to the emergency department with any of these risk factors. And we work to optimize, because some people don't even know that they have high cholesterol or high blood pressure or even might be diabetic. We want to get ahead of that and treat that so they don't have an adverse event.