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The first chest pain hit Heather Bardeleben as she pored over a spreadsheet while working late into the evening at her suburban Chicago home.

When her husband, Bill Bardeleben, suggested she lie down, she brushed off the pain with "I'll be fine."

But throughout the evening and night, Heather noticed her arms felt heavy. Meanwhile, the pulse oximeter that she used to monitor her severe asthma showed her oxygen levels dropping during each wave of pain.

By the next morning, after a fitful night of intermittent chest pressure, dizziness and other symptoms, "I knew instinctively it had to be heart-related," she said.

She was able to get an appointment with the cardiologist she saw once a year for her high blood pressure. She had an in-office electrocardiogram, or EKG, a test that examines the heart's electrical activity. She was told that it came back normal. In a 10-minute visit, the doctor told Heather her symptoms sounded like anxiety or gastroesophageal reflux, also known as heartburn.

That same day she also saw her primary care doctor. "It feels like something is trying to kill me," she told him.

Although he ordered a cardiac MRI, he also referred her to a gastroenterologist because he, too, thought the problem was likely reflux.

A few days later – and unable to get in for a cardiac MRI – Heather called her primary care doctor again, saying she was now in "agony." He told her to go to the emergency room, where she'd be able to get the cardiac MRI done more quickly.

At the ER, a series of tests came back normal. But because of her continuing chest pain, Heather was admitted to the hospital. Nitroglycerine pills helped some, but the pain continued. Even so, a hospital cardiologist told her to go home, again saying she merely had anxiety or reflux.

"There's nothing wrong with your heart," he told her. "I don't know why you're here."

Heather asked for an angiogram anyway, knowing that her parents both had received stents in arteries after the X-ray procedure had revealed blockages. But the hospital doctor sent her home, saying her symptoms didn't warrant one.

About a week later, Heather and Bill settled in to watch TV while their then-18-year-old daughter, Ashleigh, was out mini-golfing with friends. As Heather bent to sit on the couch, she felt a snap in her chest, like a twig breaking, and "knew something was horribly wrong."

The previous year, following her father's heart bypass surgery, she'd bought a device that detects heart arrhythmias to have on hand as a precaution. She pulled it out and used it. It showed a type of irregular heart rhythm called atrial fibrillation.

"I'm in trouble," she thought, just as she vomited, broke into a sweat and told Bill to call 911.

The EMTs found her on her hands and knees in the bathroom, unable to move because of the pain.

"The last thing I remember was the EMT trying to put the leads on me and commenting that I looked a little sweaty," Heather said. "Then I was gone."

She awoke in the ambulance, screaming as an EMT stuck a needle into her shin to give her fluids and medication. The EMT told her they'd revived her when her heart stopped in the bathroom.

This time at the ER, Heather underwent an angiogram. The test revealed that a piece of plaque had broken off and clotted, causing a heart attack, which then caused a cardiac arrest. She had a cardiac catheterization procedure to have a stent inserted into her right coronary artery. Doctors also found about a 70% blockage in the left anterior descending artery – or LAD, which supplies a large portion of the blood to the left side of the heart – but decided not to place a stent there.

About 10 days after getting home from the hospital, Heather again felt chest pain. Her cardiologist said it was probably just her body getting used to the new stent. She should call again if the pain grew as severe as before the procedure.

Two nights later, Heather woke up with worsening chest pain. "Oh no, not again," she thought and told Bill to call 911.

The same EMT she'd talked to in the ambulance the first time arrived. "Oh my gosh," he told her, "we didn't think we'd see you again."

At the hospital, she was told an angiogram showed that spasms in her arteries had led to a second heart attack. The 70% blockage remained in the LAD; doctors again opted not to put in a stent.

Three months later, Heather received a pacemaker and an implantable cardioverter defibrillator to counter her irregular heart rhythm and jolt her heart back into rhythm if necessary. It was late 2020 and still at the height of the COVID-19 pandemic, so that likely factored into the decision to send her home a couple of hours after the procedure. By the next morning, she was back in the ER, again with chest pain.

This time, when a doctor told her everything was fine, Heather pushed back.

"There's something wrong," she told him. "I'm telling you, there's a problem."

The doctor agreed to order an echocardiogram, or an ultrasound of her heart, and keep her in the hospital overnight for observation. The ER was full of COVID-19 patients, so they moved Heather to a room away from the commotion but with no heart or oxygen monitors. Not long after, with Bill at her bedside, she took a couple of bites of a sandwich and said, "I'm going to throw up again," as Bill called out for help.

She remembered only a member of the hospital's crash team asking, "How're you doing?" before she lost consciousness. Her heart had stopped again. That's when Bill and a nurse called Heather's identical twin sister, Nikki Stauffer, who had come to the Chicago area from Grand Rapids, Michigan, to stay with Ashleigh while Bill tended to Heather. Come to the hospital – now, the nurse said, fearing she may be saying goodbye.

When Stauffer and Ashleigh got to Heather's room, Bill was in the hallway outside, overcome with emotion.

"He was broken," Stauffer said. "I thought she was gone."

Her sister's heart had stopped again, but again the crash team had gotten her back.

Heather's heart would stop five times that night. Finally, she received a stent in the LAD that had been 70% blocked.

More than four years later, Heather, now 52, feels "incredibly grateful" to be alive and appears to have suffered no heart or brain damage. She said she was lucky that her brain wasn't ever deprived of oxygen for long because her heart had always stopped in the presence of EMTs or in the hospital, and that Bill had been nearby to call 911 twice.

She has lost 65 pounds, keeps tabs on her heart rate and ends her workday around 5:30 p.m. to try to limit stress.

She also urges friends and family members to advocate for themselves in medical situations – to seek additional testing or a second opinion when they don't get answers. If they're refused a test, she advises them to ask that the denial be recorded in their chart. She's learned, she said, that doctors can make mistakes.

"Not being an advocate nearly cost me my life," Heather said. "I should not be here today."

She also wants doctors to take women's heart attack symptoms more seriously. When Bill later went to the hospital for chest pain, she said he received an angiogram without having to ask. It irked her that things were easier for him, which she believes is because men are treated differently than women.

"I was told I had reflux or anxiety, that it was anything but my heart," Heather said.

After her twin sister's experience, Stauffer insisted on a full battery of cardiology tests, which found an abnormally fast heartbeat that needed medication and monitoring. Women, she said, need to speak up – and to be taken seriously.

"Women and our medical needs are so often dismissed or made to be more insignificant than what they are," Stauffer said. "The fact that it nearly cost my sister her life – it angers me towards the medical profession."

After surviving two heart attacks and her heart stopping six times, Heather said she gets a different response when she complains of any abnormal feelings in her chest.

"Now," she said, "they take me seriously."

Stories From the Heart chronicles the inspiring journeys of heart disease and stroke survivors, caregivers and advocates.