February is Heart Health Month, spotlighting the No. 1 cause of death for men and women in the United States.

Although the death rate from cardiovascular disease has decreased steadily over the past decade, it still claims more than 2,150 Americans every day — or one death every 40 seconds.

Knowing the signs and symptoms and what actions to take can help prevent deaths from heart attack and stroke. In communities where there is good awareness about the Chain of Survival, survival can improve to almost 20 percent.

Some heart attacks are sudden and intense — the “movie heart attack,” where no one doubts what’s happening — but most heart attacks start slowly. Mild pain, discomfort or shortness of breath may be symptoms. Often people are not sure what is wrong and wait too long before getting help.

Here are signs that may mean a heart attack is happening you should seek medical attention:

Chest discomfort. Most heart attacks involve discomfort in the center of the chest that lasts more than a few minutes, or that goes away and comes back. It can feel like uncomfortable pressure, squeezing, fullness or pain. It often begins or worsens with physical activity

Discomfort in other areas of the upper body. Symptoms may include pain or discomfort in one or both arms, the back, neck, jaw or stomach.

Shortness of breath with or without chest discomfort. Other signs may include breaking out in a cold sweat, nausea, or lightheadedness

Some may experience a combination of any of the above symptoms.

As with men, women’s most common heart attack symptom is chest pain or discomfort. But women are somewhat more likely than men to experience some of the other common symptoms, particularly shortness of breath, nausea or vomiting, and back or jaw pain.

The American Heart Association estimates that most cardiac arrests that happen outside the hospitalhaveonlya5to10percent survival rate.

However, CPR provided by a bystander immediately after cardiac arrest, can greatly improve a victim’s chance of survival.

More people survive sudden cardiac arrest when 9-1-1 dispatchers coach bystanders in assessing victims and starting immediate CPR.

When a bystander recognizes a cardiac event and calls 9-1-1 for emergency assistance, they form the first link in the Chain of Survival. The rest of the chain then continues with early CPR, defibrillation, advanced life support and ends with post-cardiac arrest care.

In our communities, 9-1-1 is usually answered by a dispatcher who has been trained in emergency medical dispatching. That dispatcher can assist in most emergencies over the phone, including instruction on CPR.

People who are not trained and who come across someone who needs CPR are often afraid to act in case they do something wrong.

But the chances that you will hurt somebody, even if it is not a cardiac arrest, are very small. Acting quickly and calling 9-1-1 could save their lives.

Since 2008, the American Heart Association has encouraged bystanders who are faced with an unresponsive and not breathing or gasping adult to start giving hands-on CPR right away.

Research has shown that skipping mouth-to-mouth does not reduce the chances of survival in the first few minutes of CPR, and has shown that compressions often start about 1 minute sooner this way.

The key factor in improving outcomes is starting chest compressions and initiating the emergency 9-1-1 call as early as possible.

Being involved and learning CPR can save lives. Call your local American Red Cross at 1- (800) 733-2767 to find out about classes in your area.

KELLIE MURPHY is a registered nurse at Bath Iron Works and a member of the Sagadahoc Board of Health.