Heart disease is the No. 1 killer of American adults today.

In the last 50 years, there have been incredible advances in the way we prevent, diagnose and treat heart disease. From massive public awareness campaigns to help adults adopt heart-healthy habits, to changes within the medical community to improve treatment options, there is a concerted effort to curb this health crisis.

Thanks to a rapid response system with CPR, and aggressive treatment in emergency departments and intensive care units, the risk of death has decreased dramatically. In fact, if you make it to a hospital, your risk of dying from a heart attack is less than 10 percent.

And while everyone seems to be fully aware that heart disease remains the leading cause of death, a recent report from the Centers for Disease Control (CDC) shows that only 31 percent of Americans are aware of the five most common early warning symptoms of an impending heart attack. This is very important, as the more quickly we seek care, the better the prognosis.

The bottom line: The symptoms of a heart attack have changed. Fifty years ago, the "classic" heart attack was extremely common — hundreds of thousands of middle-aged men experienced a sudden onset of crushing chest pain, profuse sweating, severe anxiety and a strong sense of imminent death. More than half of these attacks were fatal. Today, heart attacks are occurring at a later age, the symptoms are less typical and women are as likely to experience a heart attack as men.

Here are the five most common early warning signs of a heart attack:

— Chest pain.

— Pain or discomfort in the neck and jaw.

— Pain or discomfort in the arm, shoulder or back.

— Sudden feeling of profound fatigue.

— Sudden shortness of breath.

The CDC-conducted survey reached more than 41,000 people in 14 states. The majority of adults were aware that chest pain was a common early symptom of a heart attack and, when present, were likely to immediately call 911. However, most were not aware that the pain is often mild, frequently manifesting as pressure rather than pain in the traditional sense.

A very small number of individuals recognized the other four warning symptoms of a heart attack; hence, when they had only one symptom, they were less likely to consider seeking immediate help.

Women are more likely to ignore the early warning signs of a heart attack than men. What's more, women tend to seek help later, and when seen by a physician, the diagnosis is often missed or the symptoms erroneously ascribed to a minor ailment. As a consequence, women are much more likely to die from an acute heart attack than men.

Heart disease in women accounts for more deaths than the other seven most common causes combined. Despite huge awareness campaigns, most women still maintain the erroneous belief that coronary artery disease is predominantly a "man's disease."

If you experience any of these early warning symptoms, do not ignore them and immediately seek help. It is particularly important never to ignore a symptom that has never occurred before. For example, if you have never had indigestion or heartburn, don't blame a new pain in the chest or throat on a gastrointestinal problem.

Similarly, unless there has been an obvious injury, don't attribute a sudden onset of pain in the arm, neck or chest to a muscle strain or back problem. A heart attack is diagnosed by an EKG, as well as blood tests. Of course, because the symptoms are atypical, a complete evaluation may indicate another less serious cause. However, even if the symptoms seem inconsequential, it is better to be safe than sorry.

Many factors contribute to an increased risk of heart attack, including: being a male or a post-menopausal female, or having a strong family history, high blood pressure, elevated cholesterol, diabetes, cigarette smoking, a sedentary lifestyle and poor diet. Sadly, even if you have none of these risk factors and seem the least likely individual to have a heart attack, you are still at risk. We all must know and be able to recognize the five early warning signs of a heart attack. If you suspect you may be having a heart attack, call 911 and take an aspirin. Early intervention is an absolute lifesaver.

Dr. David Lipschitz is the author of the book "Breaking the Rules of Aging." To find out more about Dr. David Lipschitz and read features by other Creators Syndicate writers and cartoonists, visit the Creators Syndicate Web page at www.creators.com. More information is available at www.drdavidhealth.com.

COPYRIGHT 2008 CREATORS SYNDICATE INC.