One can do pretty much everything right and still be at risk. Genes play a big role.That's my story. Was diagnosed at 17 with high blood pressure, early 20s with cholesterol issues - and both father and grandfather died of heart disease. I had been seeing a cardiologist regularly for over 20 years, taking meds, working out, and watching what I was eating, and keeping my weight in line.

3 years ago, at the ripe old age of 43, I began my morning as usual by working out (no problems), grabbed my cup of coffee and headed up to my home office to start the day. I began having what I thought was stomach pain (I've had acid reflux before - and that was EXACTLY what the pain felt like.) That was my only symptom. The pain went away in about an hour, but came back late in the afternoon (not during any exercise.) I tried Maalox, etc., but the pain wouldn't go away, so I just went to bed. Woke up at about 2:30 a.m., feeling nauseous and sweaty in addition to the pain, rolled over and went back to sleep. In the morning, I felt a lot better, but still had a bit of stomach pain and did notice (for the first time) a very slight ache in my left wrist and slight ache in my jaw area. My wife (fortunately) nagged me to call our family doctor to make an appointment to have my "stomach" checked out. The doctor, noting my symptoms, did an EKG (normal) and an cardiac enzyme blood test (not normal.) At that point he summoned the paramedics and I was off to St. Pete's.

By the time I got to the hospital, I felt completely normal again. Everyone was telling me that I had a heart attack and I simply couldn't believe them. It was just that freakin' acid reflux, I thought! Everyone else had to be wrong! Come on, I felt fine!

Bottom line: I did indeed have a heart attack. Totally blocked right coronary artery. Fortunately, it was well downstream and I had only minor heart damage. Angioplasty, two stents, and 3 years later - I have no physical limitations, and I picked up fishing as a stress-busting hobby. I also understand that I am very fortunate.

Lessons Learned:
1) You can do a lot to put yourself in the best position to avoid heart disease, but this doesn't mean that you don't have it, or that you can escape an eventual heart attack.
2) For many people, heart attack symptoms don't match what you see on t.v. or the movies.
3) Be aware of what's going on in your body. Certainly note the symptoms that VHawk and others have mentioned, but also know that indigestion or stomach pain that arises out of nowhere can be cardiac related. Don't ignore unexplained pain, nausea, sweating, aching wrist, or jaw.
4) Don't just think "it will go away." For me, the symptoms did go away, BUT I still had a heart attack. Doh!
5) Better to be safe or even embarrassed by a run to the ER that turns out to be something other than a cardiac event... than dead. (Okay, there might be fishing in heaven, but I for one, need all the practice I can get before then!)