Brian Miller doesn't know it, but he is suffering his second heart attack in four months.
He is 36 years old. And he's not alone.
The baseball world continues to reel from the death of St. Louis Cardinals pitcher Darryl Kile, who died in his sleep June 22 after suffering a heart attack due to blocked arteries - atherosclerosis - in his Chicago hotel room.
Thanks to his age, 33, and celebrity, the tragedy has been front page news. Instinct might lead some to chalk up Kile's death as an aberration. But experts say early onset of heart disease is an epidemic in waiting, a ticking bomb ready to detonate.
"Obviously Darryl Kile is very visible in this case. But no, it's not uncommon, even among 33-year-olds. It happens more in older age. But it does begin in childhood and progress through time," says Dr. Robert Bonow, president of the American Heart Association. "It will probably get worse with time. The younger generation is not observing healthy lifestyles. They are not being trained to exercise a whole lot. They're eating bad stuff - fast food. There's more tobacco use."
Toss in increased obesity, cholesterol levels and family history and you've got a recipe for disaster.
Bonow, a cardiologist and professor at Northwestern University, says an estimated 61 million Americans have some form of cardiovascular disease. One million deaths annually are attributed to heart disease, including 250,000 like Kile, who die with little to no advance warning.
But that's not entirely true in Kile's situation. Reports have surfaced that the pitcher experienced pain in his arm, which can be attributed to offseason surgery. What cannot be overlooked is that Kile's father died after having a heart attack at age 44, a tell-tale sign of potential problems for his son.
"I've already heard people say, 'How could this ballplayer have a heart problem without any symptoms?'" Miller says. "I was the same way. I didn't have any warning signs at all. I just woke up in the middle of the night with chest pains."
That's not exactly true, either. Miller had noticed difficulty walking up the stairs to bed in his townhouse, but figured his loss of breath was because of a poor diet and little exercise. Coincidentally, the night of the attack he was planning to start an exercise regimen the next day.
At the hospital, Miller, the father of four and married to wife Benita for 16 years, underwent a series of tests.
EKG? Normal. Stress test? Miller didn't finish it because he was out of breath, but he and doctors attributed that to his first thought of bronchitis.
He took three nitroglycerine pills at regular intervals. They didn't help.
It wasn't until Miller had dye injected through a catheter originating in his leg that doctors found the five blockages at the heart of his attack.
The next day, doctors at St. Joseph Medical Center in Towson, Md., inserted four stents to perform angioplasty and open the blockages.
Dr. John Hornbaker, director of the Cardiac Diagnostic Center at Robinwood Medical Center, recommends a check-up for immediate relatives whenever a male family member suffers a heart attack at age 55 or younger, and at 65 or younger in women.
Unfortunately, the warning is rarely heeded.
"Most 25 to 30 year olds probably don't think along those lines at all. They're feeling fine and doesn't matter what their mother has, what their father has," says Chambersburg Hospital cardiologist Dr. Timothy Walsh. "Yes, it can happen to anyone, and age in and of itself is not a prevention. A 35-year-old can't say, 'Well, I'm just 35, I can't have heart problems.' That's just not true."
Miller, a forklift operator at a Food Lion warehouse in Greencastle, certainly never considered heart disease as the root of his problems.
Unlike Kile, there is no family history of heart problems; until his March attack, only a grandfather in his 80s had succumbed to heart attack.
Now it's easy to see how his health deteriorated. Miller had played softball regularly when younger, but had gotten away from activity recently. His diet had taken a similar nosedive, and he had packed on some weight onto his five-foot 10 inch frame.
Hornbaker doesn't think enough people recognize the importance of a healthy lifestyle.
Lay off fatty foods. Hide the salt shaker. Eat more fruits and vegetables, including leafy greens.