With a grant to write, publications due, papers to check and lectures pending, Evelyn Clingerman's plate wasn't just full Ð it was overflowing. So the assistant professor at the University of Texas at Austin's School of Nursing tried to ignore the severe chest pain that struck early on a Sunday morning.

"My first thought was no, this can't be É I have way too much to do this week," Clingerman recalls. "I'm embarrassed to say that I actually considered sitting down at my desk to see if the pain would pass."

Fortunately, she didn't do that, but sought the opinion of her anesthesiologist husband, Steve. He told his wife that busy or not, she needed to get to the emergency room fast.

They got to Seton Northwest Emergency in six minutes flat. And largely due to that quick action Ð and later on, due to the diagnosis and treatment provided by Drs. Vivek Goswami and Juhana Karha, two dedicated physicians with the Austin Heart physicians group Ð Clingerman became a heart disease survivor rather than a heart disease statistic.

The nursing instructor is telling her story in hopes that it will be a wakeup call for other women Ð a reminder that cardiac problems don't just happen to middle-aged, overweight males, which is the popular perception, but can strike women, too, and at any point in life. Even exceptionally fit and health-conscious individuals such as herself are susceptible.

According to the American Heart Association (AHA), cardiac disease is the No. 1 killer of women, exceeding breast cancer and claiming one life every minute. Females 60 and older are in the highest risk category, the AHA points out. So at age 61, Clingerman fit the profile, although nothing else about the patient indicated that she was a likely candidate for coronary artery disease.

"I worked out five or six days a week Ð generally three days with a personal trainer," the patient points out. "I kept a diary of my food intake, made it a point to watch my weight and I thought I was doing everything possible to prevent heart disease. Even in the ER, my test results were good. The EKG turned out OK, I had normal blood pressure, my resting pulse was low and cholesterol and lipid tests were fine. I kept telling everybody I qualified to be an AHA poster child."

Yet, she couldn't dismiss the chest pain that oxygen and nitroglycerin had relieved. It was worrisome and suspicious.

Truth known, Clingerman had experienced some odd episodes even before the severe pain hit. There was the time when she was working out on the Stairmaster, got to her usual high level, suffered shortness of breath and couldn't go on. But after discontinuing her exercising and walking the track with her personal trainer, the indigestion-like feelings passed. "I thought maybe I had eaten too much before exercising," she reflects.

Later on, she went back to the Stairmaster and tried it again. There was no incident.

Another time, the nursing instructor was working at her home computer. Suddenly, overwhelmed by extreme exhaustion, she had to log off and lie down on the floor for a nap. This was really strange, she explains, because she'd never been one to take naps and usually could work for hours on various projects without taking a break. Still, she didn't think too much of it, attributing the odd occurrence to being overly busy.

Goswami, a diagnostic expert who serves as clinical assistant professor at Texas A&M Health Science Center and director of nuclear cardiology at Austin Heart, believes many women move into a denial mode when experiencing what could be an early warning sign. Complicating the issue is the fact that warning signs can be confusing and atypical in females. Things such as extreme fatigue, sleep disturbances, throat tightness and shortness of breath come into play Ð weird and often nebulous little changes in the individual's normal health pattern. They bear checking out, just in case they mean bigger troubles are brewing.

But unfortunately, busy women usually brush them off as "nothing important," or make indefinite plans to check them out at a more convenient time.

Clingerman, for example, told the ER staff she wanted to wait until the weekend for further testing, explaining that her "to do" list would be shorter by then. Fortunately, conscientious staff members on duty insisted that she remain hospitalized for at least 23 hours for monitoring. And the following morning as she was being set up for a stress test with tracer medication, Goswami was called in on the case.

"I have to say that the patient looked the picture of health to me," the diagnostic expert declares. "There was nothing we could pinpoint at first."

The chest pain did not return as Clingerman underwent the stress test on the treadmill. Returning to her room, she confidently started packing to go home. Then Goswami came in, closed the door and dropped a bombshell. They'd discovered a defect on the left side of her heart.

"I didn't think it was possible," Clingerman says. "I asked him if he had the right chart."

Goswami assured the patient there was no mistake, and that a coronary angiogram/heart catherization (an x-ray procedure to see what arteries are clogged) should be the next step. Once again, Clingerman wanted to delay the test. Couldn't they do this procedure on Friday when the school week was over?

Goswami, who completed his cardiovascular research fellowship in clinical outcomes at the University of Texas Health Science Center in San Antonio and served a clinical cardiovascular fellowship at the Mid America Heart Institute in Kansas City, Mo., had learned that delay in cardiac cases could be lethal.

"Your students might not have a teacher if you wait until Friday," he told Clingerman.

Clingerman chose to be transferred to the Heart Hospital of Austin, a highly respected and award-winning Central Texas specialty hospital that offers a full range of cardiovascular services, plus cutting-edge cardiac technology. Founded by the Austin Heart physicians group, it also boasts some of the most extensively trained and dedicated doctors around, including Karha, an interventionalist who is the director of vascular imaging at Austin Heart.

Karha came to the United States from Finland at 17 and soon stacked up some impressive credentials, including a degree from Northwestern University Medical School, an internship and residency at Brigham and Women's Hospital at Harvard University and a specialty in cardiovascular medicine and interventional cardiology through the Cleveland Clinic Foundation. Working in tandem with Goswami, he outlined what would happen as they continued to explore Clingerman's problems.

The patient then entered the angiogram suite.

The angiogram showed there was a 95-percent occlusion of the left anterior descending artery (LAD), the major vessel to supply the heart with blood. This artery also is called "the widow-maker"Ñand for very good reason. If it gets completely clogged with platelets of a ruptured cholesterol plaque, it will cause a massive heart attack, which almost always leads to death. Some say from the minute a widow-maker hits, there is a scant five-minute window of opportunity to get emergency care. And that's pretty scary.

Sometimes bypass surgery is recommended in such cases. Other times, depending on the situation and a variety of health and emotional factors, a stent to keep the artery open and blood circulating properly is the medical option advised. Stenting was the choice for Clingerman; Karha operated to insert the device.

All of this happened last September. Goswami continues to monitor the case and reports, "so far, so good." The stent is doing its job; the patient is taking the necessary blood-thinning medications regularly and has an upbeat attitude. The question, however, remains: Why did heart disease hit someone who focused on a healthy lifestyle?

"Possibly it was genetics that caught up with me," Clingerman muses. "Members of my family were big on meat and potatoes É when I was younger, I didn't always count the calories or watch the fat content of foods. I got to be around 50 pounds overweight before I decided to take control of my eating habits."

Goswami emphasizes, "The development of atherosclerosis or blockage in the arteries is a normal process of aging. While conventional risk factors, such as hypertension, diabetes mellitus, smoking, high cholesterol and a family history can accelerate the process, oftentimes it is still unavoidable. There are other non-conventional factors, such as inflammation, that contribute to this process, and that is why ongoing clinical medical research is so essential."

There are, however, a number of proven steps a person can take to lessen the chances of a cardiac incident. The short list: Don't smoke. Avoid high-fat and high-caloric foods. Keep your weight under control. Get regular physicals. Keep track of your blood pressure and cholesterol levels. And don't turn into a couch potato. Granted, it's tempting to chill out on the sofa after a tough day at the office. But, warns Goswami, a sedentary lifestyle can be very bad news for the heart. Therefore, his prescription is a life filled with heart-strengthening physical activity.

Thanks to campaigns like the American Heart Association's Go Red for Women, such practical advice is getting widely publicized, and as of late, statistics are encouraging.

"From the moment the American Heart Association launched Go Red for Women in 2004, it quickly became a national movement," declares Erika Holland, executive director of the AHA's Capital Area Division. "As a result, we have nearly doubled the percentage of women who now realize that heart disease is their top health threat."

However, Holland adds, this is no reason to relax. "We are still losing more than 430,000 women each year to the problem, and that means one woman out of every three." Therefore, we must keep on spreading spread the word, she says. The awareness campaign must go on.

Clingerman would be the first to agree. The busy nursing professor has learned that full plate or not, heart health is a priority.

For more information about Heart Hospital of Austin, visit www.hearthospitalofaustin.com