At 31, she had a heart attack while cycling in the Rocky Mountains

For Carrie Lehtonen and two friends, a 60-mile bicycle ride in the Colorado Rockies was all in a day's fun. Sure, there would be pain involved, including burning lungs and aching muscles. That was to be expected.

But on this July day, Lehtonen struggled in different ways.

The then-31-year-old cyclist and triathlete soon lagged behind her friends. She felt lightheaded and nauseous, as if she had indigestion. Her shoulders and neck throbbed. Short breaks and a lunch stop helped, but the minute she hopped back onto the bike, the discomfort returned. During the final 10 miles, which were mostly downhill, she felt an odd pressure in her chest.

At the end of the ride, the trio returned to their departure point, the home of rider Keith Guastella in Longmont, Colorado. He and Lehtonen were relatively new co-workers who lived in neighboring towns. He'd heard what a strong rider she was, so he was surprised to have seen her struggle.

Inside, they all watched a bit of the Tour de France on TV and rested. Lehtonen sipped a carbonated drink, hoping it would help settle her stomach, then went to the restroom.

After many minutes, Guastella grew concerned and went to check on her.

"Are you all right?" he said through the door.

"I'm not sure," she said.

He opened the door and found her on the floor, curled up in pain.

Guastella knew something was wrong.

At a hospital, doctors performed several tests. They first suspected gall bladder or gastrointestinal issues. Nothing appeared out of the ordinary.

The doctor returned and said, "I see you have a family history of heart disease."

Lehtonen hadn't even thought of that. Now that she considered it, her eyes filled with tears. Both her grandparents had heart problems, and her father had two heart attacks in his 40s. Lehtonen always told her doctors about her family history. The doctor acted on her family history and ordered another blood test. It indeed showed possible trouble with her heart.

Once the on-call cardiologist arrived, Lehtonen was rushed to the cardiac catheterization lab so doctors could examine the internal workings of her heart.

The cardiologist discovered Lehtonen had experienced a heart attack due to a blood clot in her coronary artery. He broke up the clot and inserted a stent to keep the blood flowing. He told Lehtonen that he suspected she had plaque buildup that broke off in the artery, then the blood clotted around it.

"If you hadn't come in tonight, you wouldn't have been with us tomorrow," he said.

She spent three nights in the intensive care unit and a fourth night in a regular room before being released on a Wednesday. She was told she could return to work the following Monday.

Because of Lehtonen's age and overall health, doctors told her that cardiac rehabilitation wasn't needed. She soon started exercising again, and even did another triathlon the following summer. She had occasional dizziness, likely due to the beta blockers and other medications she was taking.

About a year after her heart attack, a co-worker connected Lehtonen with a representative from the American Heart Association's Go Red for Women. Lehtonen became interested in becoming a health coach, along with yoga and mindfulness.

"As I got into it, I realized that I really needed to get more control over my stress and my mind," she said. "I was a type A perfectionist who put a lot of pressure on myself and focused fully on my career. My near-death experience opened my eyes to the fact that I needed to change."

In 2011, two years after her heart attack, Lehtonen took on a less stressful job. She also trained to become a holistic health practitioner and yoga teacher. She transitioned to a vegan diet. She started a side business for health coaching and teaching yoga. In 2015, she began to lead yoga retreats around the world. Two years later, she married. And in 2018, Lehtonen left her corporate job to focus on her own business. She and her husband, John Busch, now live in Evergreen, a mountain community southwest of Denver. She teaches several yoga classes and leads three to five yoga retreats a year, both in Colorado and internationally.

Lehtonen, now 47, continues to cycle, mostly mountain biking, and enjoys hiking, cross-country skiing and paddle boarding.

"My heart history is always there in my mind, but I try to do the best I can to be as healthy as possible," she said.

Part of Lehtonen's mission is making sure that women know about heart disease.

"It's the No. 1 killer of all Americans, including women," she said. "Too many people die from heart disease, and I believe we can change that. I want to help others get off the hamster wheel and lead healthier and happier lives."

Guastella, the fellow cyclist who insisted on Lehtonen going to the hospital, said he has followed Lehtonen's transformation over the years and sends her a yearly birthday greeting.

"Not only did she heal, she took heart disease as her cause and went on to help other people," he said. "That's really something to be proud of."

He also uses Lehtonen's experience as an example to educate people.

"I've told her story to all my friends and family," he said. "You expect heart attacks to happen to people who are older, overweight smokers. It just shows how everyone needs to be aware."

Stories From the Heart chronicles the inspiring journeys of heart disease and stroke survivors, caregivers and advocates.