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."

Here are a dozen symptoms that may signal heart trouble.

1. Anxiety. Heart attack can cause intense anxiety or a fear of death. Heart attack survivors often talk about having experienced a sense of "impending doom."

2. Chest discomfort. Pain in the chest is the classic symptom of heart attack, and "the No. 1 symptom that we typically look for," says Jean C. McSweeney, PhD, RN, associate dean for research at the University of Arkansas for Medical Sciences College of Nursing in Little Rock and a pioneer in research on heart symptoms in women. But not all heart attacks cause chest pain, and chest pain can stem from ailments that have nothing to do with the heart.

Heart-related chest pain is often centered under the breastbone, perhaps a little to the left of center. The pain has been likened to "an elephant sitting on the chest," but it can also be an uncomfortable sensation of pressure, squeezing, or fullness. "It's not unusual for women to describe the pain as a minor ache," McSweeney says. "Some women say the pain wasn't bad enough even to take a Tylenol."

Women, more so than men, can also experience a burning sensation in their chest, rather than a pressure or pain.  "Sometimes people make the mistake that the pain comes from a stomach problem," says Nieca Goldberg, MD, clinical associate professor of medicine at the NYU Langone Medical Center in New York City and another expert on women's heart symptoms.

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One of the keys to leading a healthy life with diabetes is to keep your glucose levels, or blood sugar, in check. As your main source of energy, glucose plays a big role in keeping your body working like it should. If you have either type of diabetes, you need to be aware of symptoms that may mean your glucose is out of balance.

If your blood sugar is too low:

Andrea Kolligian has learned that she's likely to get well-meaning comments if she eats a donut. "Can you eat that? Are you sure you can eat that?" a friend or coworker will ask. Kolligian, an administrative assistant at the Dana-Farber Cancer Institute in Boston, was diagnosed with type 1 diabetes when she was a teenager, and has been taking insulin ever since. But like many people with type I diabetes, she's learned that the growing prevalence of the type 2 form of the disease, which is often...

Your brain can be affected if your sugar level drops too low.

Low glucose can cause you to stagger, slur words, or even pass out.

What to do: It's smart to wear a medical bracelet or necklace that lets people know you have diabetes.

If your blood sugar gets too low, taking in about 15 to 20 grams of a simple carb may help. Some examples are a half a cup of orange juice, 2 tablespoons of raisins, or a tablespoon of sugar.  Glucose tablets and gel tubes are also available. Some people keep an injectable hormone called glucagon on hand and tell their friends how to give them the shot in case they faint or can’t swallow. Ask your doctor if keeping glucagon on hand is right for you.

If you still don't feel like yourself after drinking juice or getting a glucagon shot, call 911. If your blood sugar returns to your target range, eat a meal or snack to prevent it from dropping again.

Always let your doctor know if you had an episode of low blood sugar. Your treatment plan may have to be adjusted.

If your blood sugar is too high:

It's normal to release as much as 84 ounces of urine a day -- that's about 2 liters. Since you probably don’t measure your urine output at home, you may have to figure out whether you're making too much of it.

What to do: “Waking at night to urinate and urinating larger amounts than usual can mean something is wrong,” says David Michael Erani, MD. He is an endocrinologist at Joslin Diabetes Center in Boston and an instructor of medicine at Harvard Medical School. People with an overactive bladder or men with an enlarged prostate may urinate frequently as well. But as long as the actual amount has not increased, it doesn’t necessarily mean you have uncontrolled glucose.

Being thirstier than usual can be brought on by warm weather, salty foods, or an increase in your workout routine. But your thirst can also be brought on by too much urination.

What to do: Continue to drink when you're thirsty. If you're dehydrated, though, you may need medical care.

Thirst may mean “your body is signaling you to drink more,” says Fernando Ovalle, MD. He is director of the Diabetes & Endocrine Clinical Research Unit at the University of Alabama at Birmingham School of Medicine. Urinating and drinking more than a gallon a day is a signal that something is wrong.

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