Studies show heart attacks and heart disease are under-diagnosed in women, as their symptoms do not match that of men. To prevent a heart attack from sneaking up on you, watch for these seven little-known signs of heart attack:

Fatigue | More than 70 per cent of women reported extreme fatigue in the months prior to their heart attacks. This was an overwhelming fatigue that sidelined them from their usual schedules for a few days at a time.

Insomnia | Despite their fatigue, women who’ve had heart attacks remember experiencing unexplained inability to fall asleep during the month before their heart attacks.

Anxiety and stress | Stress has long been known to up the risk of heart attack. But what women report is the emotional experience; before their heart attacks they felt anxious and stressed, more than usual.

Indigestion or nausea | Stomach pain, intestinal cramps, nausea, and digestive disruptions are other signs reported by women heart attack patients.

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Shortness of breath | Women couldn’t catch their breath while walking up the stairs or doing other daily tasks.

Flu-like symptoms | Clammy, sweaty skin, along with feeling light-headed and weak, can lead women to wonder if they have flu when, in fact, they’re having a heart attack.

Jaw, ear, neck, or shoulder pain | Many women say they felt pain and a sensation of tightness running along their jaw and down the neck, and sometimes up to the ear, as well. The pain may extend down to the shoulder and arm– particularly on the left side–or it may feel like a backache or pulled muscle in the neck and back.