Three elderly people died at the Southwestern Vermont Medical Center after suffering heart attacks while shoveling snow in the aftermath of the Valentine's Day storm, said the hospital's chief cardiologist, Scott Rogge.

Heart problems after a snow storm are common, but Rogge said the three fatalities was unusual. The hospital also treated 10 patients for non-fatal cardiac problems attributed to shoveling.

"All these folks had warning signs and chose to ignore them," Rogge said. The warning signs include chest pains, unusual shortness of breath and sweating.

At Fletcher Allen Health Care in Burlington, there was one shoveling-related heart attack fatality, said hospital spokesman Collin Parker.

Rogge said the higher-than expected number of cardiac cases in Bennington were caused by the extreme cold, the amount of snow and the late start to the winter season. More than three feet of snow fell in some parts of Vermont last week.

"Sometimes these people can't even make it to the emergency room if they collapse in their driveway," Rogge said. "The important thing is that people are aware. Don't think it's a pulled muscle, don't think it's indigestion. Get yourself checked out."

Rogge urged people who are going to be shoveling to use caution and common sense. He suggested using a smaller shovel, and taking regular breaks. He said there was less strain in moving several small shovels full of snow rather than one large shovel full.