The report, based on a survey of more than 500 women, busts a popular myth about the sudden nature of heart attacks.

A heart attack can strike suddenly. Think agonising chest pain that spreads to your arms and neck. While this depiction captures the imagination, heart attack symptoms often come on much more gradually.

Harvard Health cites a survey of more than 500 women who survived heart attacks.

The survey revealed that 95% of women said they noticed that something wasn't right in the month or so before their heart attacks.

Two most common early warning signs were fatigue and disturbed sleep.

Some women, for example, said they were so tired they couldn't make a bed without resting.

Chest pain - a common early warning sign of heart trouble for men - was further down the list for these women.

Those who did have it tended to describe it as pressure, aching, or tightness in the chest, not pain.

Even when their heart attacks were under way, only about one-third of the women in this study experienced the "classic" symptom of chest pain.

Instead, shortness of breath, weakness and fatigue, a clammy sweat, dizziness, and nausea topped the list.

Commenting on the findings of the survey, Harvard Health says: "One take-home message is that some women may get an early warning of an impending heart attack in the form of excessive tiredness, disturbed sleep, or shortness of breath."

The health body continues: "Paying attention to these symptoms and getting prompt diagnosis and treatment just might stave off a full-blown heart attack.

"Some men also have early warning signals, with chest pain being the most common."

It adds: "The other message is that women and their doctors need to think beyond chest pain when it comes to what women experience as a heart attack blossoms.

"Instead of writing off shortness of breath, fatigue, cold sweat, dizziness, and nausea as signs of something that will pass, everyone needs to give these symptoms a second."

How to respond to a heart attack
The NHS says: "While waiting for an ambulance, it may help to chew and then swallow a tablet of aspirin (ideally 300mg), as long as the person having a heart attack is not allergic to aspirin."

Aspirin helps to thin the blood and improves blood flow to the heart.

"In hospital, treatment for a heart attack depends on how serious it is," explains the NHS.

The two main treatments are:

Using medicines to dissolve blood clots
Surgery to help restore blood to the heart.
How to reduce your risk in the first place
Making lifestyle changes is the most effective way to prevent having a heart attack (or having another heart attack).

The British Heart Foundation recommends the following:

Eat healthily
Be physically active
Keep to a healthy weight and lose weight if necessary
Don't smoke
Cut down on alcohol
Control high blood pressure
Control cholesterol levels
Control blood sugar levels (if you have diabetes).
Get advice on healthy living.

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