heart trouble months before a heart attack occurs. This isn’t run-of-the-mill fatigue but the debilitating kind you’d typically associate with having the flu.
Scary stat: More than 70 percent of women in a National Institute of Health study reported extreme fatigue in the weeks or months before having a heart attack.
Top clues: Fatigue comes on suddenly, without any clear explanation such as extreme exertion, lack of sleep, or illness. Typically you’ll start the day with close to normal energy but become increasingly tired, feeling exhausted by the afternoon. A heavy feeling in the legs is another sign. Women should be particularly alert for unexplained, long-lasting fatigue.
What to do: Call your doctor and schedule a checkup.
A decrease in oxygen levels — caused by changes in the heart due to heart disease — may trigger subtle changes that lead to anxiety, insomnia, and agitation that can’t be explained by normal circumstances. Looking back, people who’ve had a heart attack often realize they began to experience anxiety and insomnia in the months before the attack. This may be the body’s way of trying to let you know that something’s not right.
Scary stat: Two landmark studies, one published in Circulation and a follow-up study in the Annals of Behavioral Medicine, found a strong association between self-reported symptoms of serious anxiety and a risk of fatal coronary heart disease.
Top clues: Sudden onset of insomnia when you haven’t experienced this problem before is a signal to watch out for. It can take the form of trouble falling asleep or unexplained middle-of-the-night waking. Racing thoughts or unexplained feelings of dread or impending doom are also clues.
What to do: Ask yourself whether the anxiety is related to recent events or triggers, or whether it seems abnormal in proportion to life events. Sudden, unexplained anxiety or insomnia should be discussed with your doctor.
Pain in the Shoulder, Neck, Jaw or Arm
While chest pain is a well-known sign of heart attack, it’s much easier to miss this sign if the pain mimics typical shoulder, neck, or jaw pain. Damaged heart tissue or angina — pain from a blocked artery — sends pain signals up and down the spinal cord to junctures with nerves that radiate out from the cervical vertebrae.
The pain may travel up the neck to the jaw and even to the ear, or radiate down the