Every minute of delay in getting proper treatment for a suspected heart attack or stroke increases your risk of death and disability. Getting emergency angioplasty after a heart attack or a powerful clot-busting drug after a stroke can save lives, for example, but only if treatment occurs within about three hours of the attack, preferably much sooner.

Unfortunately, many people fail to get prompt, proper treatment. Some fail to recognize the symptoms of those attacks and thus delay seeking care. Others end up in a hospital emergency room that doesn't respond adequately to the problem. This occurs especially frequently in women, since they often experience less dramatic--and thus harder to identify--symptoms, and since doctors tend to treat them less aggressively than they do men.

Here's how both women and men can spot the warning signs and increase their chances of getting proper treatment.

Crushing chest pain--the telltale symptom of a heart attack--is usually enough to motivate the person or family members to call 911. But roughly one-third of people who have heart attacks experience no chest pain at all and wait eight hours, on average, before getting to the emergency room. Heart attack without chest pain is particularly common among women. Other groups at increased risks are nonwhites, people older than age 75, and individuals with a history of heart failure, stroke, or diabetes.

One or more of the following symptoms--with or without accompanying chest pain--might signal a heart attack:

• Sudden, unexplained shortness of breath, faintness, nausea, sweating, or intense fatigue.
• Intense indigestion or a burning sensation in the chest.
• Heart palpitations.
• Sudden, unexplained pain in the center of the chest, back, shoulders, abdomen, or jaw.

If you think you're having a heart attack, immediately take nitroglycerin (if you have a prescription) or an aspirin--preferably by chewing it--and call 911.

Classic signs and symptoms of stroke include:

• Weakness, numbness, or tingling in the face, arm, or leg on one side of the body.
• Difficulty speaking or understanding words.
• Vision loss, particularly in only one eye.
• Severe dizziness, unsteadiness, or lack of coordination, or an unexplained fall.
• Severe, unusual headache, often with vomiting and then loss of consciousness.

Women and, to a lesser extent, older people, are more likely to experience subtler symptoms, such as unusual or unexplained headache; disorientation; hiccups, nausea, or general weakness; or heart-related symptoms, including chest pain, breathlessness, and palpitations.

To increase your chance of getting to the emergency room fast, and being treated properly once you get there, take these steps:

• Identify ahead of time hospitals in your area that perform emergency angioplasty and that have instituted special programs for stroke treatment. If you suspect you're suffering a heart attack or stroke, ask to be taken to one of those facilities if at all possible.
• Call 911. A January 2004 study found that people who took an ambulance to the hospital received emergency care faster than those who used private transportation, even though those who drove usually reached the hospital a few minutes earlier. That's because emergency-medical technicians can begin treatment as soon as the ambulance arrives. While you wait for the ambulance, unlock the door then sit or lie down. Drive yourself only as a last resort.
• Tell the ambulance and emergency-room staff that you think you are having a heart attack or stroke. If your symptoms don't include the classic ones, tell the ambulance crew and the emergency-room physicians that your symptoms may not be typical, and mention any risk factors you have for such less common signals.