Unlike the dramatic Hollywood heart attack, many heart attacks start slowly. Often, a person doesn’t even realize what is happening. Symptoms also vary, so even someone who has already had a heart attack may experience different symptoms a second time.

Here are the things that can indicate a heart attack:

• Pain, pressure, or constriction in the chest

• Discomfort that spreads to the shoulders, arm,
back, neck, or jaw

• Nausea or vomiting

• Indigestion, heartburn, or a choking feeling

• Shortness of breath

• Sweating

• Rapid or irregular heartbeats

• Vague feeling of illness

• Anxiety or a feeling of doom

• Dizziness, weakness, or lightheadedness

• Sudden, overwhelming fatigue

As you can see, there are numerous symptoms. Many are indistinct and could easily indicate another condition such as indigestion, muscle strain, the onset of flu, or an adverse reaction to medication.

However, if you are over 50 and have risk factors for heart disease — such as being a smoker, diabetic, overweight, or have high cholesterol, high blood pressure, or a family history of heart problems — you must take the symptoms seriously.

Of course, you can have a heart attack even if you don’t have risk factors and are not over 50. In my own case, I had a blocked artery at age 48. When the pain started in my shoulder, I thought I had strained a muscle. The pain was uncomfortable but not severe, so I did nothing about it.

But the next day it was much worse. Still, it took me 24 hours to put together what was happening and get treatment. In hindsight, I should have gotten checked out the first day.