In animals, cold shock response is perhaps the most common cause of death from immersion in very cold water, such as by falling through thin ice. The immediate shock of the cold causes involuntary inhalation, which if underwater can result in drowning. The cold water can also cause heart attack due to vasoconstriction; the heart has to work harder to pump the same volume of blood throughout the body. For people with existing cardiovascular disease, the additional workload can result in cardiac arrest. Inhalation of water (and thus drowning) may result from hyperventilation. Some people are much better able to survive swimming in very cold water due to body or mental conditioning.
Hypothermia from exposure to cold water is not as sudden as is often believed. A person who survives the initial minute of trauma (after falling into icy water), can survive for at least thirty minutes provided they don't drown. However, the ability to perform useful work (for example to save oneself) declines substantially after ten minutes (as the body protectively cuts off blood flow to "non-essential" muscles).
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The physiological response results in temporary breathlessness and vasoconstriction.
It is possible to undergo physiological conditioning to reduce the cold shock response, and some people are naturally better suited to swimming in very cold water. Adaptations include the following:
In these ways, winter swimmers can survive both the initial shock and prolonged exposure. Nevertheless, the human organism is not suited to freezing water: the struggle to maintain blood temperature (by swimming or conditioned metabolic response) produces great fatigue after thirty minutes or less.
Bacteria express a well-defined set of proteins after a rapid decrease in temperature, which differ from those expressed under heat shock conditions. Cold shock proteins may include helicases, nucleases, and ribosome-associated components that interact with DNA and RNA. Processes such as cold signal perception, membrane adaptation, and the modification of the translation apparatus are involved.