Heart attacks can strike quietly, without the dramatic scenes often portrayed in movies. Knowing the lesser-known signs can make the difference between life and death — for you or someone you love.

A heart attack occurs when the blood supply to the heart is interrupted, usually due to a blocked coronary artery. Without enough oxygen and energy (ATP), heart cells begin to die within 20–30 minutes, leading to permanent damage. Unlike cardiac arrest, where the heart stops electrically, during a heart attack the heart still beats — often struggling for hours.

Here are 10 heart attack signs that often go unnoticed:

1. Chest Pressure
The classic symptom, often described as tightness, heaviness, or a squeezing sensation. While more common in men, women also experience it — frequently alongside other symptoms.

2. Shortness of Breath
Feeling winded while resting or doing minimal activity is common, especially in older women and those with diabetes. In men, it’s often paired with chest pain.

3. Cold Sweat
Clammy skin can indicate the body’s stress response, activating the sympathetic nervous system due to pain, low oxygen, or falling blood pressure. When combined with dizziness or nausea, it’s a major red flag.

4. Referred Pain
Pain that radiates to the left arm, neck, back (especially between the shoulder blades), or jaw — especially common in women. Men more often feel it in the shoulder or arm. Sometimes, this pain occurs without chest discomfort.

5. Nausea or Abdominal Discomfort
Triggered by the vagus nerve — the long cranial nerve connecting the brain to most internal organs. Strong signals from dying heart cells can mimic indigestion or stomach flu. This is more common in women.

6. Dizziness or Lightheadedness
Due to reduced blood and oxygen to the brain. This symptom can resemble dehydration or low blood sugar, but heart-related dizziness tends to come on suddenly.

7. Extreme Fatigue
Not your everyday tiredness. We’re talking about feeling wiped out by small tasks, like brushing your hair. In some women, this may be the only symptom.

8. Anxiety or Panic Attacks
A sense of dread, chest tightness, rapid heartbeat, and sweating. This response is tied to low oxygen and the brain’s fear center taking over due to poor blood supply. Often misdiagnosed, especially in women.

9. Heart Palpitations or Arrhythmias
Fluttering, racing, or irregular heartbeats can happen when the heart is under stress. It’s due to oxygen and ATP depletion disrupting electrical signaling. Though more reported in women, it’s dangerous for both sexes.

10. A Vague Sense That Something Is Wrong
Some people just “know” something isn’t right. This intuitive warning is often the body’s subconscious response to internal distress. It’s frequently reported by elderly women — and men who are in tune with their body.

What to Do:
If you or someone you’re with experiences these symptoms, call emergency services immediately. Don’t drive yourself — symptoms can worsen quickly. Most importantly, don’t ignore or brush off vague symptoms. Denial or embarrassment can be deadly.

The good news? Most heart attacks are preventable through lifestyle and awareness. Learn to recognize the signs — and share this information with those you care about. It could save a life.