As seen in Women''s Day magazine

Kathie Gruber''s heart stopped twice on her son''s 16th birthday, October 14, 1999. The 49-year-old wife and mother had felt lousy all day. "This chest discomfort is just a cold settling in my chest," she thought. A doctor had given her a clean bill of health just a month before. She blamed her shortness of breath, fatigue and aches in her arms and legs on her smoking.

But when Kathie broke into a cold sweat, her son called 911. She was taken to Barnes-Jewish Hospital where the emergency room staff quickly recognized she was having a heart attack. "I was shocked," Kathie says. "My chest pain wasn''t intense like you see on TV so I never dreamed I was having a heart attack."

Her situation got worse. Her heart attack resulted in cardiac arrest. The Barnes-Jewish Hospital and Washington University (WU) cardiac team had to restart her heart twice.

The Barnes-Jewish Hospital cardiac team performed emergency cardiac catheterization and implanted a stent to open Kathie''s artery. She was critically ill, but she persevered.

Four weeks later, WU cardiac surgeons at Barnes-Jewish Hospital performed bypass surgery to revascularize the rest of Kathie''s arteries. After surgery, Kathie''s heart wasn''t strong enough to pump on its own so she was placed on an artificial pump called a right ventricular assist device (RVAD). At that time, Barnes-Jewish Hospital was only one of three hospitals in Missouri to have an RVAD. "I realized how lucky I was to be at Barnes-Jewish Hospital," Kathie says. "Otherwise, I would have died."

Alan Braverman, MD, a WU cardiologist at Barnes-Jewish Hospital, has cared for Kathie since her heart attack. He says the fact that Kathie''s earlier heart disease symptoms went unrecognized is common. "There''s a misconception that coronary artery disease doesn''t occur in women," he says. "But coronary artery disesase is the most common cause of death in women. Importantly, symptoms of coronary disease are often different in women than in men."

The WU cardiologists at Barnes-Jewish Hospital have a heightened awareness of women and heart disease. They are nationally recognized as leaders in cardiac care. Studies show the more patients with heart disease a hospital treats, the better their outcomes.

Kathie''s recovery has surpassed expectations. Three times a week, Kathie has cardiac rehabilitation at The Heart Care Institute, a partnership of Barnes-Jewish Hospital and WU in west St. Louis County. "I like the HCI because it''s staffed with cardiac nurses, and cardiologists are in the same building," Kathie says. "I feel safe exercising under their supervision."

Kathie advises other women to be their own advocate, to be assertive and not settle for a diagnosis of "it''s nothing." "I''ve talked with several women who have had heart attacks and none had the ''typical'' symptoms," she says. "Women and their doctors need to recognize the differences and take action."