Sudden cardiac death after manual or automated snow removal.

To examine the proximate circumstances of sudden cardiac death (SCD) in the setting of major snowstorms, we reviewed records from the medical examiners' offices of 3 counties in the weeks before, during, and after 2 heavy snowfalls that occurred in the greater metropolitan Detroit area. Of those who experienced SCD due to atherosclerotic cardiovascular disease (n = 271), 36 (33 men, 3 women) were engaged in snow removal, representing the largest number of exertion-related deaths after heavy snowfalls reported to date.