You might be able to plan a romantic evening, but would you be able to recognise the symptoms of a heart attack?

More than 40 per cent of heart attacks may go undetected because sufferers fail to spot what’s going on, according to research.

Although most people associate heart attacks with chest pains, victims can experience a range of different symptoms such as nausea, breathlessness and neck pain.

“Doctors have known for some time that certain patients, particularly the elderly and those with diabetes, can suffer a heart attack without knowing it,’’ says Professor Peter Weissberg, Medical Director at the British Heart Foundation.

“Knowing the symptoms and acting quickly could be the difference between life and death.’’

But unfortunately the symptoms of a heart attack aren’t cut-and-dried. Classic symptoms may trigger an alert but less common signs of a heart attack can be mistaken for a bad case of the flu or even indigestion, research shows.

The British Heart Foundation has this advice on spotting potential symptoms of a heart attack:

Classic symptoms

Crushing or vice-like central chest pain

Central chest pain that may also travel into the jaw, neck and left arm

Nausea or vomiting

Feeling very sweaty

Appearing paler or greyer than usual

Tingling/pins and needles in the left arm or hand with/without chest pain

Breathlessness

Less common symptoms

Heaviness and tingling in the right arm

Jaw/neck discomfort or a dead feeling left arm with no accompanying chest pain

Discomfort in the lower chest that feels more like indigestion

Chest pain that goes through to the upper back

Sudden palpitations

Feeling generally and non-specifically unwell

There are some people who have ‘silent’ heart attacks and get no obvious symptoms. Those with diabetes and the elderly may be more at risk of this particular type of heart attack than others.

If you feel you’re at risk, regular ECGs (electrocardiograms) will help to identify heart disease.

But taking care of yourself to begin with is the best way to keep heart attacks at bay.

Patient UK has this advice on preventing heart disease:

Quit smoking

If you smoke, stopping smoking is often the single most effective thing that you can do to reduce your risk of future illness. The risk to health falls rapidly as soon as you stop smoking but takes a few years before the increased risk reduces completely.

Exercise regularly

Anything that gets you mildly out of breath and a little sweaty is fine. For example: jogging, heavy gardening, swimming, cycling, etc. A brisk walk each day is what many people do - that is fine but it is thought that more vigorous exercise is better. To gain most benefit you should do at least 30 minutes of exercise on most days.

Healthy diet

Eat at least five portions of a variety of fruit and vegetables per day and try to reduce your intake of fatty foods such as fatty meats, cheeses, full-cream milk, fried food and butter. Also try not to add salt to food, and limit foods that are salty.

Limit alcohol

Don’t drink too much alcohol. A small amount of alcohol (1-2 units per day) may help to protect you from heart disease. However, too much can be harmful.

Trim figure

You don’t need to get to a perfect weight. If you are obese or overweight you can greatly reduce you health risk by losing 5-10 per cent of your weight. This is often about 5-10 kg (11-22 lb).

Checks

Have your blood pressure checked at least every 3-5 years. High blood pressure usually causes no symptoms, so you will not know if it is high unless you have it checked. A cholesterol check is usually advised if you have an increased risk of developing heart disease. A high level of cholesterol adds to your increased risk but can be lowered with treatment.

Regards