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You’d totally know if you were having a heart attack, right? You’d clutch your left arm in pain, immediately fall down to the floor, and head right to the hospital.

Eh, not so much. Heart attacks look way different in women. While, yes, many women experience chest and arm pain, it’s entirely possible to have a heart attack without these symptoms, says Jennifer Haythe, MD, a cardiologist and co-director of the Women’s Center for Cardiovascular Health at Columbia University.

Other sneaky heart attack symptoms you need to know include jaw pain, shortness of breath, extreme fatigue, dizziness, back pain, nausea, hot flashes, indigestion, and even something that feels like an anxiety attack.

Heart disease is the number one killer in the U.S. for women (men, too!) and is responsible for one in three female deaths, according to the American Heart Association. But “too many women don’t realize that heart disease is the greatest risk to their health,” says Dr. Haythe. “Women need to be even more educated because they’re more likely to have atypical symptoms.”

If that weren’t tricky enough, each individual may experience different symptoms. Here, five heart attack survivors reveal exactly what their heart attack felt like.