Sudden cardiac death after manual or automated snow removal

Chowdhury, Pertha S.; Franklin, Barry A.; Boura, Judith; Dragovic, Ljubisa J.; Kanluen, Sawait; Spitz, Werner U.; Hodak, Jerry; O’Neill, William W.

doi:10.1016/s0002-9149(03)00894-4

Cited by 25 publications

(21 citation statements)

References 16 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Other cold weather activities, such as skiing and deer hunting, similarly increase myocardial O 2 demand (4,8,25). Within 1-7 days after a heavy snowstorm, the prevalence of myocardial infarction often doubles (9,23,32). These acute coronary patients commonly present to the emergency room normothermic but with chest pain and diaphoresis.…”

Section: Discussionmentioning

confidence: 99%

Effect of cold air inhalation and isometric exercise on coronary blood flow and myocardial function in humans

Muller

Gao

Drew

et al. 2011

Journal of Applied Physiology

View full text Add to dashboard Cite

Muller MD, Gao Z, Drew RC, Herr MD, Leuenberger UA, Sinoway LI. Effect of cold air inhalation and isometric exercise on coronary blood flow and myocardial function in humans. J Appl Physiol 111: 1694 -1702, 2011. First published September 22, 2011 doi:10.1152/japplphysiol.00909.2011.-The effects of cold air inhalation and isometric exercise on coronary blood flow are currently unknown, despite the fact that both cold air and acute exertion trigger angina in clinical populations. In this study, we used transthoracic Doppler echocardiography to measure coronary blood flow velocity (CBV; left anterior descending coronary artery) and myocardial function during cold air inhalation and handgrip exercise. Ten young healthy subjects underwent the following protocols: 5 min of inhaling cold air (cold air protocol), 5 min of inhaling thermoneutral air (sham protocol), 2 min of isometric handgrip at 30% of maximal voluntary contraction (grip protocol), and 5 min of isometric handgrip at 30% maximal voluntary contraction while breathing cold air (cold ϩ grip protocol). Heart rate, blood pressure, inspired air temperature, CBV, myocardial function (tissue Doppler imaging), O2 saturation, and pulmonary function were measured. The rate-pressure product (RPP) was used as an index of myocardial O2 demand, whereas CBV was used as an index of myocardial O2 supply. Compared with the sham protocol, the cold air protocol caused a significantly higher RPP, but there was a significant reduction in CBV. The cold ϩ grip protocol caused a significantly greater increase in RPP compared with the grip protocol (P ϭ 0.045), but the increase in CBV was significantly less (P ϭ 0.039). However, myocardial function was not impaired during the cold ϩ grip protocol relative to the grip protocol alone. Collectively, these data indicate that there is a supply-demand mismatch in the coronary vascular bed when cold ambient air is breathed during acute exertion but myocardial function is preserved, suggesting an adequate redistribution of blood flow. blood pressure; sympathetic nervous system; oxygen consumption; handgrip EXPOSURE TO COLD TEMPERATURES causes many physiological adjustments, most of which help prevent a fall in core body temperature. Specifically, peripheral vasoconstriction and shivering both raise blood pressure and effectively increase the work of the heart. These are known triggers of angina in clinical populations (33). Cardiac death is highest in the winter months, even in people who spend little time outdoors (45,54). While the effects of lowered skin temperature on cardiovascular function have been extensively studied (10,29,59,60), other mechanisms likely play a role in this process.Physical perturbation of the oropharynx and larynx elevates blood pressure in clinical settings (18,34), and laryngeal cold receptors have been identified in animals (38, 51). Previous studies (26,28,35,37) have shown that blood pressure, heart rate, and/or muscle sympathetic nerve activity are increased with cold air breathing in healthy humans. Acu...

show abstract

Section: Discussionmentioning

confidence: 99%

Effect of cold air inhalation and isometric exercise on coronary blood flow and myocardial function in humans

Muller

Gao

Drew

et al. 2011

Journal of Applied Physiology

View full text Add to dashboard Cite

show abstract

“…The excitement of competition may increase sympathetic activity and catecholamine levels, and lower the threshold for ventricular fibrillation. 10 Other recreational and domestic activities that are associated with increased cardiac demands and a greater incidence of CV events include deer hunting 23 and snow removal, 24,25 both of which are associated with isometric exertion in a cold environment. Several years ago, researchers obtained ambulatory electrocardiograms (ECGs) in 25 middle-aged men engaged in deer hunting and compared the results with data obtained during peak or symptom-limited exercise testing.…”

Section: Introductionmentioning

confidence: 99%

“…In a review of records from medical examiners' offices in the weeks before, during, and after 2 heavy snowfalls that occurred in the greater metropolitan Detroit, MI area, it was found that of those who experienced SCD due to atherosclerotic CVD (N = 271), 36 people (33 men, 3 women) were engaged in manual (n = 32) or automated (n = 4) snow removal, representing the largest number of exertion-related deaths reported to date after heavy snowfalls. 25 Extreme ET-Too Much of a Good Thing?…”

Section: Introductionmentioning

confidence: 99%

Triggers of Acute Cardiovascular Events and Potential Preventive Strategies: Prophylactic Role of Regular Exercise

Franklin¹,

Lavie²

2011

The Physician and Sportsmedicine

Self Cite

View full text Add to dashboard Cite

There is now considerable evidence to suggest that acute myocardial infarction, sudden cardiac death, and stroke can be triggered by physical, chemical, and psychological stressors, including heavy physical exertion and situations that create heightened emotional stress. The increased risk appears to be largely limited to a susceptible subset of the population, that is, individuals with known or occult cardiovascular (CV) disease. In this article, we summarize the evidence supporting the impact of selected triggers in the pathogenesis of acute CV events, as well as the potential role of various preventive strategies, especially regular exercise training and improvements in cardiorespiratory fitness to reduce the CV risk imposed by various triggers.

show abstract

“…28,32,33,35 Numerous studies have described increased cardiac events with strenuous exertion in the days following heavy snow fall. [29][30][31] A rise in incidence of sudden cardiac death related to snow removal has been documented following snowstorms. 31 More complex factors undoubtedly influence this finding.…”

mentioning

confidence: 99%

“…[29][30][31] A rise in incidence of sudden cardiac death related to snow removal has been documented following snowstorms. 31 More complex factors undoubtedly influence this finding. Fortunately, our data indicate that snowy days did not have longer symptomto-door or door-to-balloon times compared to days with no snow.…”

mentioning

confidence: 99%

The Influence of Weather on the Management of Acute ST Elevation Myocardial Infarction

Curran¹,

Fort²,

Elkhateeb³

2012

DMJ

View full text Add to dashboard Cite

Sudden cardiac death after manual or automated snow removal

Cited by 25 publications

References 16 publications

Effect of cold air inhalation and isometric exercise on coronary blood flow and myocardial function in humans

Effect of cold air inhalation and isometric exercise on coronary blood flow and myocardial function in humans

Triggers of Acute Cardiovascular Events and Potential Preventive Strategies: Prophylactic Role of Regular Exercise

The Influence of Weather on the Management of Acute ST Elevation Myocardial Infarction

Contact Info

Product

Resources

About