Lose weight. You hear this advice all the time. But did you know that where your body stores those extra pounds matters for your heart health, too?

“A thicker waistline increases heart attack risk,” says Nieca Goldberg, MD, medical director of the New York University Langone Joan H. Tisch Center for Women’s Health.

Enlarged Heart (Cardiomegaly)

An enlarged heart (cardiomegaly) may have various causes. But it's usually the result of high blood pressure (hypertension) or coronary artery disease. An enlarged heart may not pump blood effectively, resulting in congestive heart failure. Cardiomegaly may improve over time. But most people with an enlarged heart need lifelong treatment with medications.

Not always, our expert says. And that's why you should know all the potential symptoms of a heart attack.

Q: I'll know I'm having a heart attack because my chest and arm will hurt, right?

A: Not necessarily. While some heart attacks do feature classic symptoms like chest and arm pain, the idea that they all do is FALSE.

About 25% of men and 40% of women don't have chest pain during heart attacks, says Harmony Reynolds, MD, associate director of the Cardiovascular Clinical Research Center and assistant professor of medicine at NYU Langone Medical Center.

With or without chest and arm pain, women may have "shortness of breath, fatigue, nausea, vomiting, sweating, palpitations, dizziness, loss of appetite, or pain in other areas such as the jaw, throat, neck, shoulders, or upper or middle back," Reynolds says.

Heart disease is the No. 1 killer of U.S. men and women, accounting for 40% of all U.S. deaths. That's more than all forms of cancer combined.

Why is heart disease so deadly? One reason is that many people are slow to seek help when symptoms arise. Yes, someone gripped by sudden chest pain probably knows to call 911. But heart symptoms aren't always intense or obvious, and they vary from person to person and according to gender.

Because it can be hard to make sense of heart symptoms, doctors warn against ignoring possible warning signs, waiting to see if they go away, or being quick to blame them on heartburn, muscle soreness, or other less serious, noncardiac causes. That's especially true for people over 65, as well as for people with heart risk factors, such as high cholesterol, high blood pressure, obesity, smoking, diabetes, or a family history of heart disease.

"The more risk factors you have, the higher the likelihood that a symptom means something is going on with your heart," says David Frid, MD, a cardiologist at the Cleveland Clinic. "People often don't want to admit that they're old enough or sick enough to have heart trouble. Putting off treatment for other medical problems might not be so bad, but a serious heart problem can mean sudden death."

Symptoms of a heart attack include:

• Discomfort, pressure, heaviness, or pain in the chest, arm or below the breastbone
• Discomfort radiating to the back, jaw, throat, or arm
• Fullness, indigestion, or choking feeling (may feel like heartburn)
• Sweating, nausea, vomiting, or dizziness
• Extreme weakness, anxiety, or shortness of breath
• Rapid or irregular heartbeats