"I thought I was invincible," recalls Leo Burke. "I thought it couldn't happen to me, not at age 54."

Chesterfield resident Leo Burke had a busy dental practice. He enjoyed spending time with his family, including his youngest daughter Gracie, and did weight training a few days a week.

"I was at my office around noon when I started experiencing severe back and chest pain," says Leo, describing the series of events on Oct. 1, a day he will forever remember. He finished up his work and went home. He tried to ignore the pain, but it persisted. Finally, a few hours after midnight, with numbness in his left arm and jaw, Leo called 911.

He was rushed by ambulance to St. Luke's emergency room, where he was given aspirin and nitroglycerin. Within a few minutes, emergency room staff did an EKG that showed Leo had ST elevation, indicating near or complete closure of one of his coronary arteries. He was whisked to the cardiac catheterization lab for an angioplasty procedure and stent placement to open up his artery - all within the first 78 minutes of arriving at the hospital.

"By 6 a.m., I was already in a room in the intensive care unit recovering," says Leo. "It was fabulous care; it was incredible," he says of the quick response.

When it comes to treatment for heart attack symptoms, quick is definitely key. Michael Klevens, MD, director of Emergency Department Cardiac Services at St. Luke's, explains that the goal is to achieve a 90-minute door-to-balloon time (the time from when a patient arrives at the emergency room with a suspected cardiac event to the time they receive a life-saving cardiac intervention).

"For every 30 minutes after that recommended 90 minutes, the death rate goes up substantially," explains Dr. Klevens. St. Luke's emergency and cardiac physicians and clinicians have worked closely to ensure St. Luke's meets the 90-minute goal, a national standard now endorsed by the American College of Cardiology, with 100 percent of patients. It means rapid diagnosis in the ER and quickly mobilizing the cath lab's physicians, nurses and technicians to provide that emergency treatment. Since studies show any delay is associated with greater risk of death, the team is actually working to exceed the national standard with a new goal of 60 minutes or less.

"Acute myocardial infarction (heart attack) is the leading cause of death in the U.S and the developing world," says Dr. Klevens. But like Leo, so many people ignore or underdiagnose the symptoms of a heart attack, not believing it could happen to them, and risk not getting the lifesaving treatment they need.

"Leo is young, worked out and took good care of himself," says James Ellison, MD, Leo's cardiologist. "It just shows how important it is to be aware of your health and pay attention to changes."

"If a person even thinks they might be having a heart-related problem, they should call 911," advises Dr. Klevens. "In reality, any intense complaint that is above the waist should be taken seriously as a possible heart attack." Dr. Klevens cautions that it's always better to risk overreacting than underreacting. "We are more than happy to tell you there's nothing wrong."

After that fateful trip to the emergency room, Leo participated in the cardiac rehabilitation program at St. Luke's, focusing on a supervised exercise regimen and lifestyle and diet modifications. Since then, he has cut back his work schedule to 25 hours a week. Friday is his designated day off, much of which he spends with Gracie and his family, which also includes his wife, two grown children and two teenage stepsons.

He also monitors what he eats, trying to stick to low-carbohydrate, low-fat and high-protein foods. He admits the hardest part is avoiding snacking with his kids. And he has continued his weight training but has added 35 minutes of cardiovascular exercise three days a week, something that was totally absent from his routine.

"I ran out to get the newspaper," jokes Leo. "But that was as far as I ran." The year after his heart attack, Leo trained for and completed a 5K run with his 26-year-old daughter.

"Leo was an avid participant in cardiac rehab and is a model patient," says Dr. Ellison, who commends him for committing to the lifestyle changes he has made.

"The most debilitating part was the depression of going through a heart attack at such a young age," says Leo, who worried that even just walking up stairs might cause a heart attack. But he found comfort in talking with others and realizing there are so many other people out there like him.

"There's no reason you can't go on to live a normal and fulfilled life," says Leo. "I'm probably in the best shape I've been in, in a long time. I feel great."

When asked about what keeps him motivated to continue his lifestyle changes, he quickly says, "If we put a value on something, we do it. I knew if I didn't exercise regularly and change my lifestyle, I'd have any early death." And Leo has clearly decided that's not going to happen to him.