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On TV and in the movies, heart attacks can be overly dramatic. In real life, heart disease isn’t always as sudden and obvious. In fact, many people are not able to recognize many signs or symptoms of heart disease.

Using data from the 2017 National Health Interview Survey, researchers assessed awareness of five common heart attack symptoms. Researchers asked a diverse pool of more than 25,000 adults in the United States. The study found that nearly 6% of respondents were not aware of any of the symptoms, and only about 53% were aware of all five symptoms.

What is Heart Disease?

According to the Centers for Disease Control and Prevention, the term heart disease refers to several types of heart conditions. Sometimes, heart disease isn’t diagnosed until a person experiences signs or symptoms of a heart attack, heart failure, or an arrhythmia.

The most common type of heart disease in the United States is coronary artery disease (CAD). As plaque builds up in a person’s arteries, it blocks or decreases the flow of blood that can get to and from the heart. A decrease in blood flow can cause a heart attack.

Heart disease is extremely common in the United States. To break down that statement into numbers:

• Someone in the U.S. has a heart attack every 40 seconds.
• More than 661,000 people died from heart disease in the U.S. in 2020.
• Heart disease is the leading cause of death in the U.S. among men and women, followed by cancer.

What Are the Symptoms of Heart Disease?

For years, typical symptoms of heart disease were focused on men, but researchers are learning that men and women experience heart disease differently.

“Cardiovascular disease is the leading cause of death among women,” says Beth Piccione, MD, FACC, a cardiologist with UPMC’s Heart and Vascular Institute. “Nothing even comes close. More women die of heart disease than men, and that has actually been a very stable trend for quite some time.” 

Symptoms can also present differently as people age, but these are common warning signs:

1. Pain or discomfort in chest

This is the most common symptom among men and women. The pain often starts in the center of the chest and can persist for several minutes. It can also start, disappear, and then return. The pain can feel like fullness or squeezing. Some people have described the sensation like an elephant sitting on their chest.

2. Pain or discomfort in the arms or shoulders

Another common symptom is pain that radiates down both arms.

3. Lightheadedness or dizziness

Feeling dizzy or lightheaded could mean you stood up to quickly or need to eat or drink. It could also be caused by low blood pressure, which could indicate that your heart can’t circulate enough blood to the body. That could lead to a heart attack or other heart problems.

4. Nausea or vomiting

Sometimes people, particularly women, experience indigestion before a heart attack.

5. Jaw, neck, or back pain

It’s unlikely that jaw, neck, or back pain alone is a sign of heart disease. However, if there’s no reason for muscle or joint pain (like a recent workout), it could be a sign of heart disease. This is especially true for women.

6. Shortness of breath

This can occur with or without chest pain. Shortness of breath when laying down is a strong indication of heart failure.

7. Extreme, unexplained fatigue

This isn’t being tired after a hard day’s work. Rather, it is suddenly feeling so tired that you can’t complete normal everyday activities. Extreme fatigue could be a sign your heart is working much harder to maintain blood flow, and decrease your ability to do physical activity over a short period of time.

8. Fast, slow, irregular, or uneven heartbeat

Prolonged changes in heart rhythm shouldn’t be ignored, as consistency is key to maintain blood flow. This symptom is especially common in women with heart disease and is often accompanied by other symptoms.

9. Excessive Sweating

Sweating while not being active could be a sign of heart disease. Night sweats are a common symptom of heart disease, and other serious diseases, for women and should not be mistaken for hot flashes.

What Should You Do?

Some people report mild symptoms that can increase in intensity while others experience sudden and intense onset. But as Elizabeth Banks demonstrates in her video for the American Heart Association, there’s no such thing as just a little heart attack.

“Always remember: Don’t ignore symptoms,” says Dr. Piccione. “And please seek attention, know what your risk factors are” 

Know the symptoms and seek medical attention if you experience any of these warning signs. The experts at the UPMC Heart and Vascular Institute are available to discuss your concerns. Call 1-855-876-2482 or visit UPMC.com/HVI to schedule an appointment.

Editor's Note: This article was originally published on February 1, 2022, and was last reviewed on June 3, 2022.