But women, premenopausal women especially, are more likely to have other “atypical” symptoms during a heart attack and often in the days or even weeks leading up to it: pain in the neck, throat, shoulder, or upper back; abdominal discomfort; shortness of breath; nausea or vomiting; sweating, anxiety, or a sense of impending doom; light-headedness or dizziness; and unusual fatigue or insomnia.