It''s the number one killer of women and it''s not Breast Cancer. It''s Heart Disease and St. Louis is the second deadliest large city, according to the American Heart Association. The AHA said Monday that nationwide, heart disease kills one woman a minute and more women than all cancers combined.

Crystal Kennedy suffered a heart attack in 2001, when she was only 39 years old, "It wasn''t like a horrible pain. It was kind of a, it was almost like a cramp".

She said suffered symptoms for two days and was initially told by her doctor that it might be indigestion,"And I was first told that it was acid reflux and that I should take a couple of Pepsid AC and prop myself up on a pillow at night".

When she finally felt left arm pain she persisted and doctors determined it was a heart attack.

Kennedy lived to change her lifestyle, but doctors say many women don''t.

"They''re less likely to survive following their first heart attack. They''re more likely to present with sudden death. In other words, no previous symptoms," explained Dr. Jennifer Lawton, a cardiac surgeon with Barnes Jewish Hospital.

It appears to be even worse in our area. According to the AHA, out of 38 large cities, St. Louis ranks second highest when it comes to heart disease deaths in women.

"The cardiac mortality for women was quite high. Women don''t eat enough fruits and vegetables in St. Louis. There are a lot of fast food restaurants. It''s not a smoke free environment, " explained Dr.Lawton. She said family history, age, high blood pressure and cholesterol, diabetes, diet and exercise are also risk factors that contribute to the high number of deaths in our area.

"Women are more likely than men to have atypical symptoms. Which may be just fatigue, not feeling well, unable to do the things you could do before, abdominal pain or discomfort or gastric burning," added Dr. Lawton. She said that may contribute to the fact that it takes longer for a woman to be diagnosed with a heart attack.

Kennedy agreed and said, many women like herself have a higher tolerance for pain and just try to manage it instead of seeking medical attention. "So my personal opinion is that people really do get symptoms, they just don''t realize that that is what is happening to them," explained Kennedy.

Dr. lawton said the best defense against heart disease is to know your risk factor. She said women should know their numbers, like blood pressure, cholesterol, lipids, blood sugar and body mass index and most importantly treat them if they''re high.

For more information on the recent study or heart disease, log on to: http://www.americanheart.org/ http://www.goredforwomen.org/