Unusual fatigue and sleeplessness may be an early warning sign for heart attack (also called “MI” or myocardial infarction) in a woman. A study of 515 women survivors published in Circulation found that 95% had such symptoms as much as one month prior to being stricken. Chest pains can be an early indicator of a heart attack, but 43 percent of women in the study said they never experienced chest discomfort. The most common symptoms were unusual fatigue (71 percent), sleep disturbances (48 percent), shortness of breath (42 percent), indigestion (39 percent) and anxiety (35 percent).

Heart disease is the number one killer of women, yet women fear breast cancer and don’t realize heart disease as a threat. Nieca Goldberg, MD, a cardiologist from Lenox Hill Hospital in New York, said the study could change the way doctors practice and could perhaps be able to intervene before a heart attack occurs, leading to better health outcomes for women. The study emphasizes the need to educate women and their doctors about early warning signs.