About every 40 seconds, someone has a heart attack in the US.

Most people imagine that having a heart attack is always intense. But the truth is that sometimes you may be unsure if your are suffering from a heart attack because the signs can be subtle and different from what you may typically think of.

This makes heart attacks very dangerous. In fact, 1 in 5 heart attacks goes unnoticed, meaning the heart muscle is damaged due to lack of blood supply — but the person is not aware of that this has occurred.

So what are the signs of a heart attack — both subtle and not-so-subtle? Here are 4 signs of heart attack to be on the lookout for:

1: Chest Pain, Pressure, Squeezing, and Fullness

Picture someone having a heart attack, and chances are you imagine them gasping for air and clutching their chest before falling unconscious. While you may experience chest pain during a heart attack, it may not be as dramatic. In some cases, it may not even be described as pain. Instead, it may feel more like pressure or squeezing in the chest.

Chest pain or chest discomfort is caused by an insufficient supply of oxygen-rich blood to your heart. During a heart attack, you may feel this pain in the center of the chest. It can last for a few minutes and disappear, or it may recur after a short break.

This symptom is a warning sign of blocked or narrowed arteries. Don’t hesitate to report this to your doctor, even if this and other symptoms are not intense.

2: Arm, Back, Neck, Jaw, or Stomach Pain or Discomfort

Heart attack pain may not be confined to the chest area. Pain or discomfort in your arm, back, neck, jaw, or stomach can also be heart attack-related.

But many people do not associate pain in these areas with having a heart attack — which may prevent them from getting immediate medical attention.

Some head-to-toe signs of a heart attack include:

Lightheadedness
Jaw, neck, or back pain
Arm or shoulder pain or discomfort
Shortness of breath
Nausea or vomiting
If you feel sudden discomfort in these areas, call 9-1-1.

3: Shortness of Breath, Nausea, and Lightheadedness

Shortness of breath can occur with or without a chest pain during a heart attack. Most people don’t realize this can happen before or after a heart attack as well—especially for women..

Research has found that shortness of breath is the third most reported symptom before a heart attack among women — and the top symptom during a heart attack.

4: Breaking Out in a Cold Sweat

Another common symptom is finding yourself breaking out in a cold sweat. The reason behind this symptom is that when you have clogged arteries, your heart requires more effort to pump blood, and sweating keeps your body’s temperature down during this extra effort.

For women, this means night sweats may not just be the result of menopause. They might also be a sign of heart problems.

If you experience any of these symptoms, make sure to consult your physician. Don’t wait until it becomes urgent.

Heart Attack Symptoms: Women vs Men
Women may experience classic symptoms — such as chest pain and shortness of breath — as many men do, but they also tend to experience stomach pain, back pain, and other non-classic symptoms.

Because of the subtlety in those symptoms, many women brush off these warning signs and already have heart damage by the time they get to the Emergency Department.

And many women put their families before their own health. But you can’t take care of your loved ones if your own health is not where it needs to be.

What Next?
So what can you do to prevent this from happening?

Talk to your physician about your heart disease and heart attack risk factors. For instance, you might be at a higher risk if you:

Have diabetes
Have high cholesterol
Have high blood pressure
Experience high levels of stress or depression
Smoke
Use alcohol excessively
Are overweight or obese
Don’t get a lot of physical activity
The risk for heart attack among different races and ethnicities can vary as well. African American, Hispanic, and white women have a higher risk of heart disease than American Indian, Asian, or Pacific Islander women.

The American Heart Association recommends getting plenty of exercise and following a healthy diet to reduce the risk of heart disease. Adopting a healthy lifestyle can ensure your heart gets the right nutrients, which can strengthen the heart muscle. The exercise-diet combination can also control and reduce high cholesterol, a common culprit behind heart attacks.