SIOUX FALLS, S.D. (KELO) — Snow is expected to return this week — and not just a little dusting but several inches to a foot or more.

That in turn will have many of us getting in an outdoor workout, one that could take a big toll on your body.

Just as those sidewalks and roads have melted off with these warmer temps, they’ll soon be covered in snow once again. While the cleanup process comes with a variety of risks, paying attention to your heart may be the most important.

Naveen Rajpurohit is a cardiologist at the Sanford Heart Hospital. He says shoveling snow, especially while out in the cold, can create a lot of stress on the heart.

“It makes our heart work really hard for the same amount of work that if we did in the better weather in the summer, it would not. The incidents of heart attacks are higher in the winter months, about 30%, as compared to the summer months, and there are many reasons for that,” Rajpurohit said.

Including a rise in blood pressure and narrow blood vessels.

“If there is a blockage there already or some sort of narrowing, that can create some chest pain or some symptoms including heart attack in patients. Also, with the cold, our heart rate goes up to keep us warm and that can again, increase the demand on the heart,” Rajpurohit said.

Rajpurohit says you should monitor for symptoms of a heart attack such as chest pain, pressure or tightening.

“Shortness of breath, sort of acute, nausea, very sweaty, clammy, dizziness, these are all symptoms to watch out for,” he said.

He says dressing well in layers and warming up with a walk in the house before heading outside are a couple of ways to get your body ready.

“Shovel for not more than 10 minutes. Take a break, go inside, drink some water. Use the snowblower — spare the shovel as much as possible,” Rajpurohit said.

Joshua Brumwell is the chief operating officer for Patient Care EMS. He says they see an uptick in calls during snow events.

“If you are experiencing symptoms, don’t wait. I encourage you to call 911, so we can come out and evaluate what’s going on and intervene early. It’s so important for outcome when care is provided early in the process,” Brumwell said.

“Call 911. Go inside. Don’t blow it off, don’t try and diagnose it yourself, get help right away,” Rajpurohit said.

Rajpurohit says it’s also important to think about your heart health all the time by eating healthy, staying active and doing your annual checkups.