Shirley Mangini watched as a nurse inserted an IV into her arm. She knew that moments later her chest would be cracked open, her heart would stop beating and a machine would control her lungs and circulation.

It was too late to consider any lifestyle changes, too late to cut down on salt and fat. Before the needle was inserted, before the anesthesia blocked her consciousness, Mangini said goodbye to her husband and two sons.

"It was the most intense moment of my life," Mangini said. "I knew I might not make it and this might be the last time I see them."

The fact that Mangini is able to tell her story means, of course, there was a happy ending -- she did make it and she lived to see the birth of her first grandchild. But Mangini is lucky, one in a million lucky. Or almost.

What led to that intense moment was a slight twinge at the top of Mangini's chest. She'd been doing some slight home improvement work -- building a garage -- that summer and thought her low energy and the small pinch were due to manual labor. Nevertheless, she decided to tell her doctor about it at her annual physical.

Mangini is a registered nurse and works at St. Peter's HomeLink. She's always been vigilant about her good health, especially since her mother suffered a heart attack at age 57 and died of another heart attack at age 62.

"Sometimes family history is more important than exercising and healthy eating," Mangini said.

So, that September Mangini decided it was about time to visit with an internist -- not because she was worried about anything in particular, mostly because of her age -- she was 52 at the time.

Mangini ended up doing a stress test. Within five minutes of being on a treadmill, Mangini's blood pressure shot up and the EKG measuring her heart rhythm went crazy. She was referred to a cardiologist.

The left main coronary artery is often referred to as "the widowmaker." Mangini's left main artery was 100 percent blocked.

"Only 1 in 800,000 survive this type of blockage," said Dr. William Hull, Mangini's cardiologist. Hull added that in 30 years of practice, he's only seen one other survivor of this type of blockage.

"I always told my husband I was one in a million," Mangini joked.

Heart disease is not something to wish for, and indeed, there are many ways to prevent it. But Mangini remembers what it was like to exit the hospital after surgery and step into the fresh air. She now feels better than ever and her doctor told her she can look forward to 40 more years.

"It would be crazy to say that I am glad it happened," Mangini said, "but it's changed my focus. I feel bolder and stronger. I laugh more. Because I lived this long, I have a new granddaughter. Because of this, my husband doesn't smoke anymore."

The tip of the scar from her double bypass surgery rises from the V-neck of Mangini's bright red dress. It's her celebration dress -- she wears it on the anniversary of her surgery -- which was Nov. 3, 2004. And she'll wear it tomorrow, which is Go Red for Women Day, a nationwide movement launched by the American Heart Association to call attention to the fact that heart disease is the No. 1 killer of women over 25.

Kim Pappas is fully aware of that statistic, and the fact that one in four females in the U.S. has some form of cardiovascular disease.

She is that one in four and she is only 21 years old.

Pappas was born with a heart murmur. It didn't give her any trouble until a couple of years ago. In fact, she skied competitively during high school and was on her way to ski for Montana State University when she injured herself. She ended up at the University of Montana majoring in both history and organizational communications.

A couple of summers ago, Pappas was walking around campus on a 108-degree day, when she felt an excruciating pain in her chest.

"It was the most pain I've ever been in in my life," she said.

Pappas has undergone a few minor surgeries and she visits with a cardiologist once a month to make sure her heart is beating strong. But really, her heart condition is the last thing on her mind. She is known among her friends as a die-hard dancer and has taken every dance class she can.

"From swing to triple step to tango, I love them all," Pappas said.

Pappas watches her caffeine and alcohol intake and she doesn't smoke. And even though she attends yoga and tai chi classes in the same day, she knows not to let herself get overheated.

"I know heart disease is the No. 1 killer of women," Pappas said. "It's just not going to be me."