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With heavy snow and ice forecast for the D.C. region this weekend, doctors are urging residents to treat Sunday’s cleanup like strenuous exercise—not a job that must be finished all at once.

Major snowstorms can bring an increase in heart attacks after people exert themselves clearing driveways, said Dr. Sudip Saha, a cardiologist with Kaiser Permanente. Older adults and people who are no longer at their physical peak may face particular risk.

Cold weather causes blood vessels to constrict, which raises blood pressure. Suddenly performing demanding work such as shoveling can then place substantial stress on the heart and blood vessels, increasing the chance of a heart attack.

Saha recommends warming up and stretching before bundling up and heading outside. Residents should shovel in short intervals, take breaks and pay attention to signs of fatigue rather than pushing ahead until the entire job is complete.

Anyone who experiences chest pain or pressure should stop immediately and prepare to call 911. Severe shortness of breath, lightheadedness and dizziness are also warning signs.

Those concerned about the strain should consider asking—or hiring—someone else to handle the cleanup.