But the cardiologist confirmed that something was, in fact, wrong. The specialist sent Mele to the hospital for a cardiac catheterization, in which dye is injected into the arteries.

The test revealed a blockage in her coronary artery, as well as damage to a portion of her heart. Doctors say a muscle spasm in her heart triggered the blockage, though they aren't sure what caused the spasm.

"Spasm typically is the thing that kills young women," Ryan said. "And there are still lots of things they don't know about why it occurs."

Mele was the picture of good health, following in both her mother's and father's footsteps as a long-distance runner. But family also may have played a role in her heart attack.

Ryan said he had a sister--lean, young and athletic like his daughter--who died suddenly and inexplicably at age 27 in 1975.

"Did my sister die from a spasm of the coronary artery which precipitated an arrhythmia [irregular heart rhythm]?" Ryan said. "We will never know. But we have to wonder."

'I GOT AWAY WITH IT'

For Mele, the emotional recovery from her attack was much tougher than the physical recovery.

As a stay-at-home mom (who's also now a part-time Realtor), running was "kind of the only thing I really did for myself."

She had always taken great pride in her physical health, so stopping running was tough. She no longer runs competitively--no more marathons.

But with her doctors' blessing, Mele said she now runs 6 to 8 miles, five days a week. She also does Pilates and lifts weights.

She also takes several medicines designed to keep her from suffering another attack.

Mele said the experience reinforced the importance of listening to your body and of getting things checked out--twice, if necessary. It also taught her to take fatigue seriously and not assume it's just the price of being active.

Her attack also reinforced her belief in the importance of staying fit.

"What [doctors] said was had I not been in such good physical condition, I could have possibly dropped dead after that 18-mile run, or during that following week where my heart wasn't working properly," Mele said. "Because I was as healthy as I was, I got away with it."

Janet Marshall: 540/374-5527
Email: jmarshall@freelancestar.com