Heart disease is the number one killer of men and women in the United States.

Hollywood actor James Gandolfini’s deadly heart attack at 51 is just one high-profile reminder that it can happen to any of us at any time.

Chest pain, arm pain, and shortness of breath are the symptoms most people recognize, but there are five lesser-known symptoms you need to know to save your life.

Kim Strong is an outdoor sports fanatic.

“You name it, we do it,” said Strong, a 42-year-old heart attack survivor, who fearlessly skis double diamonds and surfs the monster waves in Costa Rica. “I don’t go down, ever!”

That changed on July 11, 2012.

“I was watching television with my husband and I said, ‘I have a weird feeling. I feel like I flossed my teeth too hard,’" Strong explained. "The next morning I had a back ache, chest pain, and the jaw pain was killing me. I told my husband that I thought I was having a heart attack. He told me, 'You are not having a heart attack,’ and then he taps me on the bootie and says, ‘Get ready, get dressed, and go to work.’”

She then collapsed in her bedroom closet. Her husband drove her to the hospital and in minutes, her suspicion was confirmed. She had a heart attack. 

“I have a blood-clotting syndrome,” Strong said.

"Heart disease hits very young people, very productive people, and that’s one of the reasons why it's very scary," said Dr. Swathy Kolli, cardiologist at Dr. P. Phillips Hospital in Orlando. 

Kolli said it’s worse if you don’t know all the signs. In women, that includes nausea, vomiting and shoulder, neck and jaw pain.

"These are the symptoms that people usually don’t pay attention to," Kolli said.

Strong did for one reason, a card. A handout at the annual American Heart Association “Go Red Luncheon” she attended two months earlier.

"No other way to say it. If I hadn’t gone, I would have pushed through it because I am a pretty tough girl," Strong explained.

Strong's extreme sporting days are over, but she said the tradeoff is worth it.

"I have to be here for my kids.  I have to see what happens," Strong said.

The major risk factors for heart disease are hypertension, diabetes, high cholesterol, smoking and family history.

Strong’s blood clotting disorder is genetic. She’s planning to have her children tested, since they have a 50/50 chance of having it, too. 

Kolli said the lesser-known factors are obesity and certain inflammatory diseases, like rheumatoid arthritis.

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