Chest tightness cold weather

In theory, stepping outside and sucking in a few lungfuls of cold air sounds invigorating. It should energize you enough to climb a mountain, open a salsa jar on the first try, or accomplish some other admirable feat. Instead, it can just feel like you’ve inhaled a lit match. Here’s why this absurd and unfair reality exists, plus what you can do if you’d rather not feel the burn.

The problem with cold air isn’t just that it’s chilly. That jerk is usually dry, too.

It’s all about how cold, dry air interacts with your airways and lungs, Jonathan Parsons, M.D., director of the Division of Pulmonary, Critical Care & Sleep Medicine at The Ohio State University Wexner Medical Center, tells SELF. (Your airways are tubes that carry, well, air between your nose, mouth, and lungs, the National Heart, Lung, and Blood Institute (NHLBI) explains.)

When you breathe in cold air, it can irritate your airways, causing their muscles to constrict, Purvi Parikh, M.D., an allergist/immunologist with Allergy & Asthma Network and NYU Langone Health, tells SELF. This phenomenon is known as a bronchospasm, and it can prompt chest tightness and burning.

There’s also the fact that your lungs are used to working with a certain level of warm, wet air, Dr. Parsons explains. That’s why one of your nose’s many duties is heating and humidifying the air you breathe. If the air is still too cold and dry when it hits your lungs, they might object. With pain. You know, since they can’t talk.

The pain and discomfort can be even worse if you’re dealing with a respiratory health condition.

If you have a health issue like asthma, your airways are already kind of fussy. Asthma makes your airways and the muscles surrounding them liable to overreact when you encounter a substance your respiratory system views as a threat, like pet dander, mold, pollen, dust mites, or…cold air. In that case, gulping a bunch of cold air (or running into some other asthma trigger) can make your airways inflamed and narrow, über-mucous-y, and also make the muscles around them constrict, the NHLBI explains.

Other respiratory conditions like bronchitis (it basically makes the tubes in your lungs become swollen mucus factories) can also cause more trouble when you’re exposed to cold air, according to the American Lung Association.

Try these tips to ease the potential pain from breathing frigid air.

There are a few little lifestyle tweaks you can try to make things easier on your respiratory system, which does a lot for you, so it would be kind of great to return the favor.

For starters, try to always breathe in through your nose, Raymond Casciari, M.D., a pulmonologist at St. Joseph Hospital in Orange, California, tells SELF. It’s better at warming and humidifying the air you breathe than your mouth is.

Another great idea: Cover your nose and mouth with a scarf when it’s cold out, Dr. Parikh says. This helps slightly warm up the air before it hits your nose (or mouth, if you do sometimes breathe through it), making it less likely that freezing air will actually reach your lungs.

If you’re planning to exercise in the cold (go you, seriously), begin slowly. “Allow your body to warm up before you start exercising heavily,” Dr. Casciari says. This gets your body used to the extra intake of cold air bit by bit instead of just shocking the poor thing.

You should be especially careful if physical activity triggers your asthma or if you have a specific form of the condition known as exercise-induced asthma, where you only experience symptoms when working out. Make sure you’re taking your medication as directed, Dr. Parikh says. Whether you rely on a quick-relief inhaler to open up your airways right before you exercise, long-term medication to reduce overall inflammation in your airways, or some combination of both, be sure to follow your doctor’s instructions. (Here’s more information about how to prevent exercise-induced asthma from ruining your workouts.)

Also, just generally pay attention to how much of a tantrum your respiratory system throws in cold air, even if you’re pretty sure you’re in perfect health. If you have a strangely hard time breathing or are dealing with symptoms like an incessant cough, chest tightness or pain, and a whistling sound when you breathe, it could actually be a tip-off that you have a condition like asthma, Dr. Parsons says. It’s possible to develop this health condition as an adult without knowing it, so if winter and your respiratory system seem to be nemeses, don’t hesitate to flag that for your doctor.


  • When to See a Doctor About That Weird Chest Tightness
  • Hey, Biology Buffs, Here’s Exactly How Asthma Works in the Human Body
  • 7 Reasons You Might Wake Up Gasping for Air

We know to guard our skin against frostbite by covering up when we go outside in sub-freezing temperatures.

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But extreme cold also can impact vital organs, such as the heart and lungs. For example, cold can make your heart beat faster, which makes your blood pressure go up, says interventional cardiologist Leslie Cho, MD.

“It’s really how the body reacts to the cold,” Dr. Cho says. “The body’s first reaction is to try to keep warm. So blood vessels constrict to keep in the heat. The heart also beats faster, which can increase blood pressure. All of that can have an impact on the heart.”

Hypothermia and the heart

A severe wind chill only makes things harder on your heart because the wind can steal even more body heat, which could lead to hypothermia, Dr. Cho says.

Hypothermia is when your body’s core temperature falls to lower than 95 degrees. It occurs when your body can’t produce enough energy to keep the internal body temperature warm enough. Symptoms include lack of coordination, mental confusion, slowed reactions, shivering and sleepiness.

For people with underlying heart disease, the extra work your body has to do to stay warm could cause chest pain and possibly even a heart attack, Dr. Cho says.

If this is you, be sure to discuss exercise guidelines with your physician, especially strenuous activity, she adds.

But even experienced winter sports enthusiasts who don’t take certain precautions can suffer accidental hypothermia. Heart failure is the cause of most hypothermia-related deaths, according to the American Heart Association.

Your heart is under even greater stress when you combine cold weather with a vigorous activity like shoveling snow or walking through heavy, wet snow or snow drifts. Take frequent rest breaks during shoveling so you don’t overstress your heart.

You should treat this type of strenuous work as you would vigorous exercise.

So it’s important to stay well hydrated by drinking fluids and to dress warmly, she says.

Cold air and your lungs

Cold air also can impact your breathing – especially if you have a lung disease like asthma or chronic obstructive pulmonary disease (COPD).

For people with COPD, cold air can trigger spasms in the lung, creating symptoms similar to an asthma attack, says pulmonologist Rachel Taliercio, DO.

“You might be more breathless, or feel out of breath, you might cough or start to wheeze. You also may feel a bit of tightness in the chest,” Dr. Taliercio says. “All of these can be signs that you should get indoors.”

Both doctors agree it’s important to dress warmly when the mercury drops and that layers are a good way to insulate your body. The layers trap warm air next to your body.

It’s also a good idea to wear a hat so heat doesn’t escape through your head. Cover your nose and mouth with a scarf so the air is warm before it enters your lungs.

Chest Pain, Acute

Step 3

Possible Causes

  • See Chest Pain in Infants and Children
  • Diagnosis

    Your symptoms may be from an infection such as PNEUMONIA.

    Self Care

    Pneumonia can be a serious health problem. See your doctor right away.

  • You may have VIRAL BRONCHITIS. Your pain may be caused by PLEURISY, an irritation of the lining of the lung that is usually caused by a viral infection. Hard coughing may also cause pain in the muscles and chest wall.

    Drink plenty of fluids, and try cold medicines and/or anti-inflammatory medicines to relieve your symptoms. See your doctor if the cough continues for more than a few days or if you develop a fever.

  • Your pain may indicate PNEUMOTHORAX, a condition in which air leaks from a lung and fills the chest cavity. This makes it difficult to breathe.

    See your doctor right away. Treatment of pneumothorax may require hospitalization.

  • You may have a serious problem, such as CONGESTIVE HEART FAILURE, ASTHMA or PULMONARY EDEMA.

    See your doctor right away.

  • These could be symptoms of HYPERVENTILATION, an episode of overbreathing often caused by stress of anxiety.


    If you have hyperventilated before due to stress or anxiety, your doctor may have given you information about treating yourself. Lie down, relax and try to slow your breathing. Try breathing through pursed lips (as if you were whistling), or cover your mouth and one nostril, and breathe through the other nostril.

  • Your pain may be from a HEART ATTACK or MYOCARDIAL INFARCTION. Note: Just like for men, chest pain is the most common heart attack symptom in women. However, women are more likely than men to experience the following symptoms (with or without chest pain) when having a heart attack: abdominal pain, feeling lightheaded or dizzy, back or jaw pain, and unexplained fatigue.


  • Your pain may be from an irritation of the stomach called GASTRITIS or an irritation of the esophagus called ESOPHAGITIS. A HIATAL HERNIA (a weakness in the diaphragm) or esophageal spasms may also cause this type of pain and discomfort.

    Try an antacid, and eat smaller, less spicy meals. See your doctor if the problem persists.

  • You may have a viral infection of the nerves and skin called SHINGLES.

    See your doctor. Shingles usually clears on its own, but medication may ease the pain and help prevent complications.

  • Your pain may be from a compressed nerve, possibly from a COMPRESSION FRACTURE.

    See your doctor promptly.

  • For more information, please talk to your doctor. If you think your problem is serious, call right away.


Hot weather

Mostly we think of asthma symptoms being worse in the winter. But hot summer weather can trigger asthma symptoms for some people too.

The causes are not clear but two possible reasons are:

  • Breathing in hot air can cause the airways to narrow, leading to coughing and shortness of breath.
  • When it’s hot in summer, there are often higher levels of pollutants and pollens in the air.

Top tips if hot weather sets off your asthma

  • Keep taking your regular preventer inhaler so you’re less likely to get symptoms. And carry your reliever inhaler with you at all times so you’re ready if symptoms do come on.
  • Use a written asthma action plan so you know what to do if hot weather triggers symptoms
  • Go for regular asthma reviews to check you’re on the right meds for you, and you’re taking your inhalers in the best way to get the benefits through the summer months
  • If you’re using your reliever inhaler three or more times a week, or you’ve noticed the hot weather’s made your symptoms worse, book an extra catch up with your doctor or asthma nurse.
  • Keep inhalers in a cool place out of direct sunlight so they continue to work well. Try keeping your reliever in a cool bag when you’re out and about on a hot day.
  • Keep an eye on pollen forecasts and find out more about why staying on top of your hay fever symptoms with antihistamines is good for your asthma too.
  • Plan any outdoor activities for earlier in the day when the air quality tends to be better, including exercise.


Thunderstorms can be an asthma trigger. Two possible reasons for this are:

  • The air before a storm can feel very humid and close. Some people tell us this gives them a tight chest and a cough, and that they find it harder to breathe.
  • During pollen season, the windy conditions during a thunderstorm blow lots of pollen high into the air. The moisture higher up in the air breaks the pollen into much smaller pieces. As these smaller pieces of pollen particles then settle back down, they can be breathed in, irritating the smaller airways of the lungs.

Top tips if thunderstorms set off your asthma

  • Keep taking your regular preventer inhaler so you’re less likely to get symptoms. And carry your reliever inhaler with you at all times so you’re ready if symptoms do come on.
  • Use a written asthma action plan so you know what to do if a thunderstorm is forecast or triggers symptoms
  • Go for regular asthma reviews to check you’re on the right medicines for you, and you’re taking your inhalers in the best way to get the benefits.
  • If you’re using your reliever inhaler three or more times a week, or you’ve noticed pollen or thunderstorms make your symptoms worse, book an extra catch up with your doctor or asthma nurse.
  • If you know thunderstorms affect you, try staying indoors before, during and after the storm, and keep the windows closed to stop released pollen getting indoors.
  • Take your usual hay fever treatments such as a nasal spray and/or antihistamines during your pollen season

Changes in weather

“One of my main triggers is a change in the weather, whether this is an increase or decrease in temperature. When this happens my chest becomes tight, I begin to cough and have to use my reliever inhaler.” Monica, age 66

Top tips to deal with symptoms when the weather changes

“Our weather in the UK is unpredictable and changes happen suddenly sometimes. So it’s important to stick to a good routine of taking your preventer inhaler every day as prescribed,” says Dr Andy Whittamore. ‘That way you’re on top of your asthma whatever the UK weather throws at you.”

  • Keep taking your regular preventer inhaler so you’re less likely to get symptoms. And carry your reliever inhaler with you at all times so you’re ready if symptoms do come on.
  • Use a written asthma action plan so you know what to do if changes in the weather trigger asthma symptoms
  • Go for regular asthma reviews to check you’re on the right medicines for you, and you’re taking your inhalers in the best way to get the benefits, whatever the weather.
  • If you’re using your reliever inhaler three or more times a week, or you’ve noticed weather changes making your symptoms worse, book an extra catch up with your doctor or asthma nurse.
  • Keep an eye on the weather forecast so you’re prepared for changes coming up.
  • Make sure you know the signs that your asthma is getting worse and what you need to do if it is.
  • Carry a small scarf around with you to go over your nose and mouth so you’re prepared if the weather turns windy or cold

Understanding your personal weather triggers

“Both my mum and me have asthma, and the weather affects us in completely different ways. My mum’s asthma is not good when it’s cold and windy; mine is triggered when it’s warm and air quality is less good.” Charlotte, Asthma UK volunteer.

“The key thing is getting to know what your weather triggers are,” says Dr Andy. “Talk to your doctor so you can add them to your asthma action plan. And try keeping a symptom diary too – you may notice you’re more likely to react to the weather when there’s other things going on too, like hay fever, colds and viruses, or bad pollution.”

‘If you know weather is a trigger, especially changing weather, then have your reliever inhaler with you at all times and stick to your routine of taking your preventer inhaler to cut your risk of symptoms.”

Last updated November 2019

Next review due November 2022

Jan. 20, 2010— — Hypothermia and frostbite are common hazards associated with severe cold, but while cold weather can cause discomfort that can be easily remedied with a trip to the pharmacy, it can also trigger previously undiagnosed deadly diseases and sometimes serious medical problems.

Dr. Marie Savard, “Good Morning America’s” medical contributor, visited the show today to talk about how you can protect yourself and recognize warning signs.

When Cold Weather Causes Breathing Trouble

It’s not unusual for cold air to cause spasms in the lung airways, making it harder to breathe. But for some people, cold air can trigger an asthma attack, which may be how the asthma is detected for the very first time.

Signs of weather-induced asthma include coughing and wheezing and an inability to catch your breath.

One way to combat these symptoms is to use a Proventil inhaler before you head outdoors. It will relax the spasms that strain the flow of air into your lungs. Check with your doctor to see if using an inhaler is right for you.

Another solution: wear a muffler or scarf around your mouth and nose. It will warm the air that you take into your lungs, which will keep your airway open.

Chest Pains Could Be Serious

If you feel chest pain when you are breathing cold air, tell your doctor immediately because it could be a sign that you have a heart condition. Just as cold air constricts the lung muscles, it can cause arteries to constrict and raise your blood pressure. For someone with an undiagnosed heart condition, simply breathing in cold air can lead to chest pain.

Even minimal exertion outdoors could trigger a heart attack, Savard said. Tell your doctor if you feel chest pain, shortness of breath or any chest discomfort or tightness in the cold.

If you already have been diagnosed with heart disease and you get chest pain in the cold, you should talk to your doctor about whether you should take a nitroglycerin tablet about 15 to 20 minutes before you go outside in winter weather.

Cold-Weather Tingles Can Be Sign of Raynaud’s Syndrome

You may have experienced tingling pain and numbness when you’ve been outside in the cold for any length of time, but 10 percent of people — primarily women — get that feeling from exposure to even the slightest cold.

Those people suffer from Raynaud’s syndrome, and any exposure to the cold — even from taking food from the freezer of a grocery store or briefly going out in the cold — can trigger spams in the blood vessels in your fingers, toes, ears and the tip of your nose.

According to the Mayo Clinic, the spasms will cause those areas of the body to feel numb and then change color — from white to blue then red. That happens because the arteries that supply blood to the skin close down, limiting blood circulation to the affected areas. In serious cases, an artery can be totally blocked, resulting in sores or even gangrene.

Sufferers can take medications to prevent attacks, especially if the condition is so severe that it interferes with your ability to function in the winter months. For others, wearing mittens to keep your hands warm will prevent your arteries from constricting. Since women are more susceptible to Raynaud’s, it’s especially important that they keep their hands and feet warm.

Winter Nosebleeds

Many people get nosebleeds in the winter. They’re not much cause for worry, Dr. Savard said. Nosebleeds commonly occur in the winter because the nasal passages get dried out and crack — either from the low humidity and cold air outside or from the dry heated rooms indoors. Use some ointment and saline drops to keep your nasal passages moist.

This winter season will bring cooler temperatures and ice and snow for some. For most people, shoveling snow may not lead to any health problems. It’s important to know how cold weather can affect your heart, especially if you have cardiovascular disease. Some people who are outdoors in cold weather should avoid sudden exertion, like lifting a heavy shovel full of snow. Even walking through heavy, wet snow or snow drifts can strain some people’s heart.

How does cold weather affect the heart?

Many people aren’t conditioned to the physical stress of vigorous outdoor activities and don’t know the potential dangers of being outdoors in cold weather. Winter sports enthusiasts who don’t take certain precautions can suffer accidental hypothermia.

Hypothermia means the body temperature has fallen below 35 degrees Celsius or about 95 degrees Fahrenheit. It occurs when your body can’t produce enough energy to keep the internal body temperature warm enough. It can kill you. Symptoms include lack of coordination, mental confusion, slowed reactions, shivering and sleepiness.

Children and the elderly are at special risk because they may have limited ability to communicate or impaired mobility. Elderly people may also have lower subcutaneous fat and a diminished ability to sense temperature so they can suffer hypothermia without knowing they’re in danger.

People with coronary heart disease often suffer angina pectoris (chest pain or discomfort) when they’re in cold weather.

Besides cold temperatures, high winds, snow and rain also can steal body heat. Wind is especially dangerous, because it removes the layer of heated air from around your body. At 30 degrees Fahrenheit in a 30-mile per hour wind, the cooling effect is equal to 15 degrees Fahrenheit. Similarly, dampness causes the body to lose heat faster than it would at the same temperature in drier conditions.

To keep warm, wear layers of clothing. This traps air between layers, forming a protective insulation. Also, wear a hat or head scarf. Heat can be lost through your head. And ears are especially prone to frostbite. Keep your hands and feet warm, too, as they tend to lose heat rapidly.

To help make snow removal safer, here is a list of practical tips.

  • Give yourself a break. Take frequent rest breaks during shoveling so you don’t overstress your heart. Pay attention to how your body feels during those breaks.
  • Learn the heart attack warning signs and listen to your body, but remember this: Even if you’re not sure it’s a heart attack, have it checked out (tell a doctor about your symptoms). Minutes matter! Fast action can save lives — maybe your own. Don’t wait to call 911
  • Don’t drink alcoholic beverages before or immediately after shoveling. Alcohol may increase a person’s sensation of warmth and may cause them to underestimate the extra strain their body is under in the cold.
  • Consult a doctor if you have a medical concern or question or if you are experiencing symptoms of a medical condition (such as heart disease or diabetes), prior to exercising in cold weather – especially if this is a substantial increase over your usual level of activity.
  • Be aware of the dangers of hypothermia. To prevent hypothermia, dress in layers of warm clothing, which traps air between layers forming a protective insulation. Wear a hat because much of your body’s heat can be lost through your head.
  • Learn CPR. Effective bystander CPR, provided immediately after sudden cardiac arrest, can double or triple a victim’s chance of survival. Hands-only CPR makes it easier than ever to save a life. If an adult suddenly collapses, call 911 and begin pushing hard and fast in the middle of the victim’s chest until help arrives.

Learn more:

  • Decongestant and over-the-counter medication information for people with high blood pressure
  • Special needs for children with congenital heart defects
  • Heart attack warning signs

Wintery Conditions Linked to Increased Heart Attack Risk

Below-freezing temperatures, strong winds, and the shorter days that come with winter weather can create a perfect storm for increasing the risk of a heart attack, according to a large scale study of nearly 300,000 people published October 24, 2018, in the journal JAMA Cardiology.

By merging data gathered from the Swedish Meteorological and Hydrological Institute with a nationwide registry of all patients who were admitted to any coronary care unit in Sweden due to a heart attack between 1998 and 2013, researchers found that the number of myocardial infarctions (MI) rose on days when the temperature dropped below freezing.

“Our results not only suggest that weather is independently associated with the incidence of MI but also that the association may differ with regard to season and electrocardiographic subtypes,” wrote Moman A. Mohammad, MD and colleagues from the department of cardiology at Lund University in Sweden.

This study confirms prior observational research that links circadian variation and a seasonal pattern to increased cardiovascular events, says Luke Laffin, MD, a preventative cardiologist at the Cleveland Clinic in Ohio, who was not involved with this research.

Temperature, low atmospheric air pressure, wind speed, and short periods of sunshine were all found to increase the risk for MI, with cold temperatures being the strongest indicator. For each 7.4 degrees Celsius (roughly 13.5 degrees Fahrenheit) increase over freezing, the risk of a heart attack was reduced by 2.8 percent.

The connection between cold weather and heart events has been noted as far back as 90-plus years ago, says Dr. Laffin, referring to a study first published in 1926 in the Boston Medical Surgery Journal, which found that most cases of coronary thrombosis in New England happened during the winter.

These findings support theories put forth in earlier studies. “A number of physiologic mechanisms have been proposed to explain the association of cold weather and MI, among which coronary vasoconstriction is the most probable cause,” Dr. Mohammad and his coauthors wrote. It appears that cold weather doesn’t affect coronary vascular resistance in healthy people, but can lead to constriction of blood vessels in people with coronary heart disease.

There are other factors at work during colder weather, the authors noted. “Respiratory tract infections and influenza are known risk factors for MI that have a clear seasonal variation that may contribute to our findings,” they wrote, citing a study published in January 2018 in The New England Journal of Medicine that showed a six-fold increase of MI seven days after a respiratory infection.

But before you give away all your down jackets and stock up on sunscreen, know that these findings shouldn’t determine where you spend your golden years, says Laffin.

“This study reinforces an observation that has been described before, and there are other observational studies suggesting an increased incidence of cardiovascular and psychiatric disease in warmer climates if individuals experience hurricanes, earthquakes, flooding, and the like,” he says.

Laffin recommends spending retirement in a location where one can and will be physically active. “Physical activity, as a key component of a healthy lifestyle, is going to decrease an individual’s risk of heart disease and improve quality of life more than just moving to a warmer climate,” he says. So if you love walking the golf course multiple days a week, retire in Arizona, but if you prefer skiing in the Rocky Mountains, that’s great too, he says.

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Cold Weather and Cardiovascular Disease

With colder weather approaching, it is important to note the particular impact of dropping temperatures on the cardiovascular system. Heart attack is the leading cause of death in the U.S. for men and women throughout the year. The probability of heart attacks, angina and other heart-related problems increases as temperatures decrease. Knowing about the link between cold weather and cardiovascular disease can save lives.

What Cold Weather Does to the Cardiovascular System

Cold weather can cause blood vessels and arteries to constrict, thus making the heart work harder to pump oxygen-rich blood throughout the body. This constriction may cause angina, or chest pain, that can also spread to the shoulders, arms or neck. Angina is a symptom of several heart-related issues, including coronary heart disease. It can also cause a spike in blood pressure.

The risk of ischemic stroke rises by 19 percent during winter among those who suffer AFib (atrial fibrillation), according to the American College of Cardiology. When AFib occurs, the heartbeat fibrillates (quivers) and does not move blood properly from the atria to the heart’s lower chambers, called ventricles. In any weather, AFib can increase the risk of stroke up to five times. An ischemic stroke happens when an obstruction occurs in a blood vessel supplying blood to the brain.

Hypothermia is another risk for the cardiovascular system. This occurs when body temperature gets dangerously low, as it can when subjected to cold weather for an unusual length of time. Hypothermia causes the heart, nervous system and other organs to function improperly and may lead to heart failure or death. Symptoms for hypothermia include weak pulse, slurred speech, shivering and confusion.

Outdoor Winter Activities Increase Risk

The image of a sudden heart attack striking someone who is shoveling snow may sound stereotypical but it is not incorrect. The strenuous activity of shoveling definitely increases risk. But it’s not the only potentially dangerous activity. Yard work, outdoor exercise programs, such as running or jogging, or hustling about rapidly are all activities that could increase cardiovascular risk. If a person is not used to physical activity, that adds a potentially dangerous element to all of these activities.

Avoiding Cold Weather Triggers

There are ways to decrease the stress of cold weather on the cardiovascular system. First, knowing if any problems already exist by having regular physical examinations helps. Also, conferring with a physician or cardiologist prior to beginning or continuing any outdoor exercise program is advisable.

As obvious as it sounds, dressing as warmly as possibly when it is cold is advisable. Dressing in layers and making sure the head and neck are covered help maintain body warmth. Additionally, taking breaks frequently during strenuous activity such as exercising or shoveling snow helps. The breaks decrease the risk of over-exertion. Dehydration is another problem often overlooked in cold weather. It is important to make sure to drink water to avoid it.

There are also preventable methods that can be taken before going out into the cold. Steering clear of alcoholic beverages is paramount among them. Because alcohol can provide a false feeling of warmth within the body, it may lead to hypothermia more quickly. Additionally, eating a large meal soon before cold weather activity should also be avoided.

Smoking is especially dangerous in cold weather, as is drinking coffee just before outside activity. Both increase blood pressure and heart rate, risk factors for heart disease.

Finally, listening to the body during exertion in cold weather is imperative. Chest pain, lightheadedness, shortness of breath and dizziness mean that all activity should stop immediately and medical attention is necessary.

To learn more about cold weather and cardiovascular disease, log on to

Here’s a scene we’re all familiar with: It’s that first, really cold day of the year, but temperatures be damned, you will not be resigned to the treadmill. So you suit up. You’ve got cold-weather gear; you got this. You head outside, get going, and while your body feels fine, every breath you take sends a burning sensation to your lungs. You stop, thinking, Why does breathing cold air hurt so much?

This is a common question, especially among new runners or runners who move to cold places. I hear it all the time from patients in my practice in Minnesota.

The lungs are amazing organs. To understand, think of a tree with two main branches splitting off from the trunk and then splitting into smaller and smaller branches until the tiny branches sprout leaves. Turn the tree upside down, shrink it to chest size, and you have an image of a lung with the trachea as the trunk and the alveoli (air sacks) as the leaves.

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Over time, your lungs evolved to warm and humidify inhaled air to body temperature and humidity without damaging tissue. This warming and humidification of the air occurs rapidly, starting in the mouth and nose reaching body temperature and 100-percent humidity before the air gets too deep into the respiratory tree. As air moves deeper into the alveoli that lie in direct contact with the blood vessels, it exchanges oxygen for carbon dioxide. While inspired air is cooling the lung tissue, the expired air adds some heat back to the cooled tissues on the way out of the lung.

Cold air is very dry. The burning sensation you feel when breathing in cold air is probably due to the combination of heat and water exchange that is occurring early in the inspiration of cold, dry air. For most people, this sensation goes away after a few breaths. It is not known to cause harm in a healthy lung, but can trigger an attack of bronchospasm in someone with asthma. Many people worry that the lung tissue will freeze in cold air, but the extensive network of blood flow through the lung tissue seems to prevent that from happening.

As best we can tell, the lungs will tolerate extremely cold temperatures without cold damage. Growing up in northern Minnesota, -40°F was not an unusual temperature, and that did not stop us from running around outdoors. There are many year-round runners in Minnesota and other northern tier states, not to mention Nordic skiers and ice skaters, who are out in very cold conditions. Our bodies seem to have developed a hardy system that will withstand the cold elements.

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If cold air bothers you during exercise, one trick that can help is wearing a scarf, balaclava, or face mask to help “prewarm” the air before you breathe it. I use a balaclava to keep my face warmer in very cold conditions and avoid frostbite on my cheeks. There are many designs that have extra materials over the mouth and nose to prewarm the air.

The bottom line: You can exercise in cold conditions without fear of damaging your lungs, and the burning sensation should pass.

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