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Winter time ... infarction time?

Heart attacks are caused by the blockage of an already atheroscleroticly damaged coronary artery. The main risk factors for atherosclerosis are well known and primarily include obesity, arterial hypertension, high cholesterol, smoking and lack of physical exercise. Statistically speaking, the probability of suffering a heart attack, differs significantly during the seasons and spikes during the Autumn and Winter months. An important trigger for coronary events seems to be the notable combination of low temperatures and physical exertion. A Canadian study found that on days of heavy snowfall, hospital admissions and death rates increased significantly because of heart attacks, linked to the physical strain of snow shoveling. Although the increase in case numbers only affected men, the makers of the study concluded that snow removal is a predominantly male task.

Previous studies already uncovered certain processes that contribute to the increased heart attack risk during Autumn and Winter. Exposure to the cold causes peripheral vessels to rapidly contract, which puts a great strain on the heart. Additionally, inhaling cold air in conjunction with physical labor slows the coronary blood flow and may interfere with the supply of oxygen to the heart. The elderly particularly appear to respond to the cold with a greater drop in cardiac perfusion. The cold may also cause the occurrence of cardiac arrhythmias by a reflex activation of the sympathetic nervous system. Even extreme physical stress can trigger a heart attack. For example, the Canadian study showed that during snow shovelling, the heart rate increased to as much as 75% of the maximum heart rate, which greatly stresses the body.

The potential triggers of a heart attack can include a flu infection as well. While the exact pathomechanism is still unknown, temporary changes of the blood's clotting properties are suspected to increase the risk of heart attack. According to observations by the University of New South Wales in Australia, between 2008 and 2010 every eighth heart attack patient was found to have been infected with the flu-virus. Consequently, they were affected twice as often as subjects from the control group. At the same time, the study showed a protective effect of the influenza vaccine on the potential risk of infarction, reducing the risk at an estimated 45%.

Due to the increased risk of cardiovascular events in Autumn and Winter, at-risk patients and those with pre-existing heart disease should take precautions. Above all, this includes avoiding intense physical outdoor activity. Older people should also consider getting vaccinated against the flu. Not only will the vaccine protect them against severe complications from an infection with the flu virus, it also appears to positively affect the risks of suffering a heart attack.

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