As a woman, you may feel that a heart attack is not the greatest risk you face, but the threat is very real--especially in the years leading up to and following menopause when hormonal changes can open the door to heart disease. Knowing the symptoms that women often experience during the early and late stages of cardiac troubles, and knowing your risk factors for cardiovascular disease, can significantly increase your chances of survival.

Heart attack warnings can be subtle. An interesting study on cardiac events in women has revealed that many women may experience prodromal--or early--symptoms of cardiac distress in the days, weeks, or even months leading up to a heart attack. Unfortunately, many of these signs may go unnoticed because they may not be considered unusual. Fatigue and sleep disturbances are two of the surprising early symptoms that might be cause for alarm.

Unusual Fatigue
Fatigue is very common. It may indicate that you are simply short on sleep, fighting a virus, or experiencing a side effect to medication. However, a recent study found that over 70% of the women surveyed who had a heart attack experienced marked fatigue in the days or weeks prior to their attacks.

Sleep Disturbances
Although it is not unusual to feel tired due to a lack of sleep or a particularly demanding week or month, women should take special notice of any unusual or prolonged disturbance in their sleep patterns. A recent study revealed that almost half of the women who had recently suffered a heart attack also experienced sleep disturbances in the days or weeks leading up to their attacks. Shortness of breath during normal daily activities appeared to be another early warning sign of cardiac distress, as were indigestion and anxiety.

Pay Attention
So how do you know if it's serious? Getting in the habit of noting your typical aches and pains and your normal reactions to foods and activities may help you begin to recognize when something truly is amiss.  Also, remember that someone who has risk factors for heart disease should be especially vigilant about monitoring how she feels. Any woman who experiences worrisome or unusual changes in her energy or comfort levels or her sleep habits should discuss her concerns with her healthcare provider. A woman who has heart risk factors, such as high blood pressure, high cholesterol, obesity, diabetes, a smoking habit, or a sedentary lifestyle, may need to pay particular attention to the way she feels and should discuss her concerns with her doctor as soon as possible to rule out heart distress.

Of female members of RealAge.com that are over 40 with cardiovascular disease:
* More than 70% have a total cholesterol over 200
* Almost 50% smoke cigarettes
* Over 80% indicate they are stressed
* Nearly 40% have a high body mass index (BMI)

Heart Attack Symptoms
Acute symptoms vary. The sudden, violent chest convulsions portrayed on TV or in movies may not be what most women experience when they have a heart attack. Although this is considered by many to be a classic heart attack symptom, research suggests that these dramatic signs may be more common in men than in women. Fortunately, we now know of several more moderate signals a woman's body sends to alert her that she is having a heart attack. Her pain may be fairly atypical in comparison with what men usually experience.

Although classic, acute heart attack symptoms such as severe chest pain may occur during an attack, women typically report pain or discomfort in other areas of the body before or during an attack, pain that may or may not feel alarming. Pressure, tightness, aching, or burning in your upper back, neck, shoulders, and arms, or even in your jaw or throat can be signs of heart distress. Women have also described the discomfort as sharpness, fullness, or tingling sensations.

Also, shortness of breath, fatigue, stomach pain, cold sweats, dizziness, indigestion, or nausea may occur during the acute phase of a heart attack. Learning about the many different acute symptoms of heart attack can help ensure that you seek emergency care when it is needed.

After 40, your risk for coronary heart disease starts to rise as your body stops producing estrogen naturally and your cholesterol levels increase. Although taking estrogen through hormone replacement therapy was initially thought to protect against heart disease, clinical trials have found that it does not offer cardiac protection and may increase the risk of heart disease and ovarian and breast cancers.

Research shows that women frequently ignore signs of illness or attribute their symptoms of cardiac distress to something else. If you are feeling unusual fatigue or pain and discomfort, do not casually dismiss it. The fact that these warning signs may occur as much as one month prior to an attack gives you valuable time to seek medical care to determine the cause.

7 Ways to Reduce Your Risk of Heart Disease
1) Stop smoking if you smoke.

2) Include fresh fruits and vegetables, whole-grain foods, and low-fat dairy products in your diet daily to get the necessary amounts of calcium, potassium, and magnesium.

3) When you eat fat, eat unsaturated fats instead of saturated.

4) Have your blood pressure checked regularly.

5) Reduce stress levels at home and work by regularly taking short breathing breaks.

6) If you drink alcohol, limit it to no more than one glass per day.

7) Get 30 minutes of exercise every day, and keep your weight within healthy limits.

Reprinted with permission from RealAge.com