She seemed so healthy. (Executive Health Package).

WHEN CLAUDETTE ELLIS WOKE ONE MORNING with severe jaw pain, she couldn't understand what was causing the discomfort. "I thought it was the way I slept," she says. Later, Ellis, who was also experiencing chest pain, fell in her bathroom. She managed to crawl to the phone, and she called for help. At age 45, she had unknowingly suffered a heart attack, losing 30% of her heart muscle.

The Columbia, Maryland, resident, now 50, exercised every day, had stopped smoking, and practiced healthy eating habits. "But I was working long hours," she says. Experiencing shortness of breath, she reported this symptom to her physician during a routine physical and further tests were ordered. Her heart attack occurred within the two weeks between her physical and her testing.

Heart disease runs in Ellis' family. Her father died from a heart attack before he tamed 40. Ellis thought she was taking proper care of her heart through diet, exercise, and routine checkups. But she had two blocked arteries that had gone undetected by previous physicians.

"At the time, the knowledge was just not out there about women my age or younger having heart attacks," Ellis says. "The symptoms we experience, such as jaw pain or nausea, are different from those of men."

In addition to watching her diet and exercising regularly, Ellis, an investigator for the federal government, takes up to eight medicines daily. She has also had five angioplasties. More than 40% of African Americans suffer from some form of cardiovascular disease.

* Know your risk factors. Age, gender, and heredity are three risk factors. Heart disease is the leading killer of women. In fact, the typical heart attack victim is a 70-year-old woman, not a 50-year-old man. Smoking, high blood cholesterol, high blood pressure, physical inactivity, obesity, diabetes, and stress are commonly cited risk factors.

"Almost a third of African Americans have hypertension versus a quarter of Caucasians," says Dr. Lynne Perry-Bottinger, a New York interventional cardiologist.

* Get tested early and often. You must actively pursue testing. Dr. Perry-Bottinger knows a patient who was forced to undergo bypass surgery because her physician, whom she had seen religiously for 30 years, neglected to order screening tests because she appeared healthy.

Recent surveys conducted by the New England Journal of Medicine found that African American patients who suffer a heart attack are less likely to be referred for cardiac catheterization than white patients, whether the physician is black or white. Cardiac catheterization is the gold standard for determining the severity of coronary artery disease and is the required preliminary step for coronary revascularization.

* Listen to your body. No one knows your body as well as you do, so don't ignore abnormal symptoms. Chest discomfort; jaw, back, or arm pain; shortness of breath; breaking into a cold sweat; palpitations; and lightheadedness can all be symptoms of a heart attack.

For more information, log on to The American Heart Association, www.americanheart.org; The National Coalition for Women with Heart Disease, www.women heart.org; and the Association of Black Cardiologists Inc., www.abcardio.org.