When it comes to heart attacks, many people think of the classic "chest-clutch and fall" scenario that you see in the movies, notes Dr. Preeti Jois-Bilowich, a cardiovascular emergency associate at the Cleveland Clinic in Ohio. But the truth is that most heart attacks aren't so obvious. In fact, many heart-attack victims -- women especially -- don't experience chest pain or discomfort at all. Instead, they exhibit one or more lesser-known symptoms.

This is a problem since only 31 percent of adults know all five major signs of a heart attack, reports Dr. Jing Fang, epidemiologist at the Centers for Disease Control and Prevention's Division for Heart Disease and Stroke Prevention.

If you’re one of the 69 percent who don’t know all five signs, here they are:

- Chest pain or discomfort, which may feel like pressure or a squeezing sensation

- Pain or discomfort in the jaw, neck or back

- Pain or discomfort in one or both arms or shoulders

- Feeling weak, lightheaded or faint

- Shortness of breath

In addition, sometimes the above symptoms are accompanied by nausea or breaking out in a cold sweat, according to the American Heart Association.

To Call or Not to Call

So now that you know what to look for, how can you tell if it's "the big one"? Unfortunately, most of the time, you can't. If one of the above symptoms develops without an obvious explanation or isn't relieved quickly with the usual remedies, that's a red flag that it's a heart attack, advises Dr. Jois-Bilowich. For example, if you haven't eaten all day and start to feel weak and lightheaded, try sitting down and eating something. Or if you suffer from asthma and feel short of breath, follow your doctor's instructions to treat your asthma (such as using your inhaler). But if the usual remedies don't work, your next thought should be: possible heart attack. 

Keep in mind that when chest pain does occur, it may not be intense. Rather, victims may experience a gnawing discomfort that won't go away, according to Dr. Jois-Bilowich. "If it's just a funny twinge that makes you think, 'Maybe this could be it,' call your primary care doctor for advice," she says. But if your doctor isn't available or it's anything more than "just a funny twinge," call 911 and talk to the dispatcher. Whatever you do, "don't sit at home and try to figure it out," says Dr. Jois-Bilowich. "The important thing is to get some sort of [medical] evaluation quickly."

Reasons to Act Fast

Receiving a timely evaluation is imperative, since medications made to stop or slow heart attacks are most effective when given within an hour of when symptoms begin. Unfortunately, only about one in five people get to the hospital during that critical time period, and more than half of deaths from heart attack occur while the patient is still in the emergency department or before they even reach the hospital, according to the American Heart Association.

So memorize the five signs, and if it looks like you or someone you're with may be having a heart attack, don't waste time. Call 911! "If you're wrong and it's not a heart attack, that's not something to be embarrassed about," says Dr. Jois-Bilowich. "You still did the right thing to get it checked out." And if your hunch is right, you may just save the life of someone you love.

Kim Schworm Acosta is the former health editor of Shape magazine and a current contributor to Fit Pregnancy and the health director of VIV. Over the past 12 years, she has also written for Family Circle, Brides, Living Fit and Looking Good Now. She lives with her husband and two children in Overland Park, Kan.

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