You know the scene. Unable to breathe, a man, usually middle-aged, clutches his chest and keels over. Often referred to as the “hollywood heart attack”–most people recognize crushing pain or pressure in the chest as a sign of a heart attack. But for women, heart attack symptoms can be far less dramatic than those depicted in the movies.

Unaware of the signs of a heart attack, many women often delay seeking medical care. But time is the best weapon when you’re having a heart attack. The sooner you can get treated, the better chance that you’ll survive.

A heart attack can occur when the blood supply to the heart muscle is cut off. When cells in the heart do not receive enough oxygen they begin to die. The more time that passes without treatment to restore blood flow, the greater the damage to the heart.

Having high blood pressure or high blood cholesterol, smoking, and having had a previous heart attack, stroke, or diabetes can increase your chances of having a heart attack. There is still a misperception, even among doctors, that heart attacks are not common in women. But heart disaease–the leading cause of heart attacks–kills more women than men each year. It’s important that you and your loved ones recognize the signs and insist on proper treatment and care if you suspect you’re having a heart attack. Your chances of survival are a lot higher if you receive emergency treatment as soon as possible.

Heart Attack Symptoms in Women

If you think you’re having a heart attack, act immediately by calling 9–1–1. While you wait for the ambulance to arrive, chew and swallow an aspirin. You should also stop all activity and try to remain calm.

As with men, a woman’s most common heart attack symptom is chest pain or discomfort. But women are also more likely to report “nontraditional” signs including fatigue, dizziness, abdominal discomfort, shortness of breath and back or jaw pain.

Chest discomfort. Most heart attacks involve discomfort in the center of the chest that lasts for more than a few minutes, or goes away and comes back. The discomfort can feel like uncomfortable pressure, squeezing, fullness, or pain.

Discomfort in other areas of the upper body. This can include pain or discomfort in one or both arms, the back, neck, jaw, or stomach.

Shortness of breath. This often comes along with chest discomfort. But it also can occur before chest discomfort.

Fatigue. Unusual or unexplained fatigue.

Other symptoms. These may include breaking out in a cold sweat or feeling nausea, light–headedness, upset stomach or vomiting. Sleep disturbance is also commonly reported.

It’s important to remember that these symptoms may come and go. Heart attacks can progress slowly and the signs many present a few days, weeks or even months before an actual heart attack occurs.

Sources: Centers for Disease Control and Prevention; U.S. Department of Health and Human Services, Office on Women’s Health