Andrea Wongsam, 13 weeks pregnant in 2004 with her first child and seemingly healthy, had no idea she was having a heart attack.
The 35-year-old from Kensington, Md., ignored the initial symptoms. Her jaw tightened, and she became so overheated resting in her car that she rolled down her windows and threw off her clothes, even in near-freezing Washington, D.C. temperatures.
But when her left arm went lifeless and the pain became so great, she drove with one hand to an urgent care center. By the time she was airlifted to a hospital, her heart had suffered major damage, and her baby was dying.
Now Wongsam, who is 42 and works in budget and finance at the National Institutes of Health, urges women to educate themselves about heart disease so that they don't face a similar fate.
She will never have children. Her fallopian tubes were tied because doctors didn't believe she could survive another pregnancy because of the heart damage.
"I was in such a dark place," she said of the pregnancy loss. "I felt embarrassed and ashamed and I made poor decisions that killed my kid. It's terrible, and I felt like I needed to help see that other women didn't do as I did."
Wongsam learned about the Go Red for Women campaign and found a "sisterhood" of others whose lives had been shattered by heart disease.
Now, during Heart Month, she and others are telling their stories to educate women about the symptoms that often go unnoticed.
An estimated 400,000 women die every year of heart disease -- 10 times more women than die of breast cancer annually -- and the vast majority of cases are preventable, according to Dr. Susan Bennett, a spokesman for the American Heart Association in Washington, D.C.
"We can control the risk factors and reduce strokes and the need for bypass surgery by 80 percent," she said.
"Women with a family history can have double or triple the risk, depending on whether one or both parents have had the disease," said Bennett.
Women who have had high blood pressure or gestational diabetes during pregnancy are also at higher risk. Other diseases, like lupus, can increase risk, as well as such cancer treatments as chemotherapy and radiation.
Those under 45 years old can have even worse outcomes than older women. "In five years, almost half of them [with heart disease] won't be around," Bennett said.
Women, younger women in particular, often ignore the signs of an impending heart attack, which are often different from the classic male symptoms.
"A lot of time it can be pressure," said Bennett. "There is a tightening or heaviness, but not necessarily pain. Some women stay at home because it's not painful enough to give me a call."
Women are also more apt to report a shortness of breath or a discomfort in the upper back or excessive fatigue.
Wongsam had no family history of heart disease. But she had a bone marrow condition that caused her body to produce too many platelets. A blood clot had formed and caused her heart attack, and she waited a dangerous six hours to get help.
"I thought I was having heartburn associated with my pregnancy," she said. "I just ignored the pain for a while, but then it got worse," she said.