It was Michelle Aurelius' final year of fellowship in forensic pathology, and she was studying fiercely with a friend for her board certification test -- the most difficult exam of her life.
When her heart started beating rapidly, Michelle figured there was more to it than stress. Instead of her normal pulse rate of 60 beats per minute, she clocked readings in the 80s. Then 120, then 150, then 180. She started to feel dizzy.
"My heart's racing!" she told her study partner. He rushed to get some ice.
"Do you need me to call 911?" her friend asked.
"No, I'm going to be fine," Michelle said.
Her heart rate returned to a normal range within 10 minutes, even though it felt like it lasted hours. Michelle, then 35, figured it was a fluke and went home to rest.
The next morning, Michelle examined the body of a 40-year-old woman. Records showed she'd died from complications of Wolff-Parkinson-White syndrome, an electrical malfunction between the heart's chambers that can produce overly rapid heartbeats. That's when it dawned on Michelle: She might have the same condition.
She walked directly from her hospital office to the emergency room about a block away. Within hours, tests confirmed it.
Her case was relatively mild. All she needed to keep it under control were some lifestyle changes. For instance, she gave up caffeine and began prioritizing more sleep and less stress.
That was 18 years ago. With those adjustments and monitoring from a cardiac electrophysiologist, Michelle has decreased the severity and frequency of her rapid pulse episodes. They used to happen several times a week -- sometimes more than once a day -- and lasted up to 10 minutes. Now, they occur once or twice a month for a minute or two.
Still, when episodes hit, they're "like a hurricane," said her husband, Dunham Aurelius.
"It can come on in and level you," he said. "It's always scary -- the thought of your wife going into cardiac arrest and she could die at any moment."
Michelle and Dunham, a sculptor, live in Sims, North Carolina, with their 13-year-old daughter, Lilly. Dunham often joins Michelle at doctor's appointments and comforts her when she's going through an episode. He, too, avoids caffeine and eats a low-sodium diet.
"I am very proud of her," Dunham said. "She's a very positive person. She's also very resilient."
Now 53, Michelle is the state of North Carolina's chief medical examiner. She thinks often about the deceased woman who led her to her diagnosis and is filled with gratitude toward her.
"I realized that as a doctor, I knew what my diagnosis probably was but … like most relatively young professionals at the time, I didn't think in any shape or form that I was having any symptoms of heart disease," Michelle said. "I didn't want to believe that I could have a disease or disorder that I needed to track. That was really humbling as a physician.
"That life-changing diagnosis really woke me up," she said. "I'm not just a doctor; I'm a patient. I need to listen to my own body. If I'm not listening to my own body as a physician, what are other women -- mothers, daughters and sisters -- doing when heart disease strikes?"
American Heart Association News covers heart and brain health. Not all views expressed in this story reflect the official position of the American Heart Association. Copyright is owned or held by the American Heart Association, Inc., and all rights are reserved.
By Kellie B. Gormly, American Heart Association News