Susan Amerikaner was sitting on the couch in her Camarillo living room, waiting for "Law and Order: Criminal Intent" to come on the television. It was Oct. 17, 2006.

In the months leading up to that night, she'd lost about 20 pounds, started walking four miles a day and made changes to her diet. She'd done so well, her doctor took her off the cholesterol and blood pressure medication he'd prescribed for her.

But Amerikaner, a freelance educational media writer, also was in the midst of a stressful assignment for work, had put exercise on hold, and her blood pressure and cholesterol were on the rise again.

"I think the perfect storm was brewing, and I didn't realize it," said Amerikaner, now 58. "All of a sudden, I felt this definite squeezing in the middle of my chest that I'd never felt before."

She said to her husband, Erik: "Honey, I think something's wrong. It must be my heart."

She was right. She was having a heart attack. When she realized it, Amerikaner was stunned.

"I remember lying there thinking, I'm now a person who's had a heart attack.' I always thought I would get cancer," she said. "I was completely astounded."

That's what many women believe. Breast cancer is the disease women fear most, according to a survey by Society of Women's Health Research, which found 22 percent of women are most worried about that disease. The surveyed women cited various kinds of cancer, including breast cancer, 57 percent of the time.

But heart disease affects far more women than breast cancer, and is the No. 1 cause of death for women in the U.S., causing 332,000 deaths each year, according to the National Institutes of Health's National Heart, Lung and Blood Institute. Stroke causes 91,000 deaths; lung cancer, 68,000 deaths; and breast cancer, 41,000 deaths each year, according to the institute.

To raise awareness of women's heart disease and urge more women to take an interest in their heart health, the institute launched the Heart Truth campaign, which uses a red dress as its symbol.

That campaign, launched in 2002, and a similar effort by the American Heart Association called Go Red for Women, seem to be working. A 2006 survey by the American Heart Association showed 57 percent of American women know that heart disease is the leading cause of death for women, up from 34 percent in 2000 and 46 percent in 2003.

Women's understanding of their personal risk of heart disease also increased, with 21 percent of women identifying heart disease/heart attack as the greatest health problem they faced in 2006 versus 8 percent in 2000, according to the survey.

"We do want to make women more aware of their health, that they're not immortal. Nobody's immune," said Dr. Valerie Kwai Ben, president of the board of the American Heart Association and chief of cardiology at Santa Theresa Medical Center in San Jose.

Lifestyle changes urged

Kwai Ben said she believes the campaign is helping in that regard, getting women to make changes to their lifestyles as well as make appointments with their doctors to go over any heart health concerns such as high cholesterol. A few simple changes can make a big difference, she said.

"Exercise daily, just walking daily for 30 to 40 minutes, choosing the right foods, controlling cholesterol — make those kinds of changes," she suggested.

Susan Amerikaner had previous incidents of chest pain or pressure, and she began taking blood pressure and cholesterol medication, but her doctor never uttered the words "heart disease." Abnormalities on an EKG test were dismissed as a false-positive, she said.

Amerikaner followed doctors' orders, though, and made some diet and lifestyle changes, including a 20-pound weight loss. The moves convinced her doctor she didn't need the medication any more. Some cardiologists believe a patient's risk of heart attack goes up when such medications are stopped, describing it as a rebound effect. That's what Amerikaner believes contributed to her heart attack.

'Take care of yourself'

While she was in the hospital, she was immediately put back on blood pressure and cholesterol medication. After she was released, Amerikaner attended cardiac rehabilitation at Pleasant Valley Hospital for several months. She returned to her routine of walking four miles a day and continues eating heart-healthy meals. A year ago, she participated in a forum on women and heart health at the Reagan Library, with first lady Laura Bush and former first lady Nancy Reagan in attendance.

She wants other women to be aware of the dangers of heart disease and to make sure they're taking care of themselves.

"Women take care of other people — they don't want to be a bother," she said, "but you have to take care of yourself, too."

On Valentine's Day last year, Erik Amerikaner wrote his wife a poem:

Roses are red,

Violets are blue.

I have to keep you alive

To keep loving you.

Then he took a personal CPR class from the American Red Cross as a gift to his wife.

This year, in a new poem, he pledged to take better care of himself. His wife's heart attack gave each of them a greater appreciation for the other, Erik Amerikaner said. The couple, who have 26-year-old twin sons, spend more time together, cooking and walking around their Leisure Village neighborhood each evening with their dog, Lucky.

"We have to take care of each other," he said. "My goal is to keep her going, and her goal is to keep me going."