The clenching and flexing of the left arm are so synonymous with a heart attack that moviegoers can tell within seconds that their favorite character is about to collapse onscreen. Within moments, the character in question has clutched his chest, dropped to his knees and is gasping for breath. While these symptoms are classic signs that a heart attack is happening, unfortunately, pop culture has missed many of the more subtle signs that a heart attack is imminent, leaving some heart attack sufferers to wonder what it is that they are actually experiencing until it’s too late.

Every year, about 1.1 million Americans suffer from heart attacks, or myocardial infarctions (MI). About 460,000 of these people will suffer fatal attacks, many of which may have had a different prognosis had the sufferer reacted quickly and been able to make it to an emergency room.

A heart attack is the most severe type of muscle pain and an indicator that a part of your heart muscle is dying. Heart attacks are commonly caused by a blockage of fatty deposits, or plaque, in a heart artery. This blockage prevents blood and oxygen flow to a part of the heart, which kills the muscle. If caught quickly, doctors usually can prevent death or severe heart damage by administering blood-thinning medicines or performing an angioplasty, which removes the arterial blockage.

Heart Attacks in Men

Symptoms of heart attacks in men and women vary somewhat, although many symptoms overlap. Men more than women are likely to experience chest pain or pressure, as well as the pain or discomfort in the left arm that Hollywood has made notorious. However, symptoms may not include chest pain, and in about 25 percent of cases, heart attacks are asymptomatic, earning them the name the “silent killer.”

Because many of the symptoms of a heart attack aren’t immediately linked, it’s important to learn the nine signs so that you or a loved one can be alerted quickly and get immediate medical attention.

Chest Discomfort

Most men – but only about 50 percent of women -- suffering from a heart attack will experience pain or discomfort in the center of the chest that lasts for more than a few minutes or that comes on, eases and returns. This can range from a feeling of pressure or fullness in the chest to a strong, sharp pain. Sometimes, this feeling can follow a period of feeling angina or a strong, dull chest pain, or it can come on suddenly and without warning.