It's a brilliant Texas morning and Susan Dancer, RN, is chasing 4-year-old daughter Rachel around the park.

"Catch me, Mommy!" Rachel shrieks, and Dancer grabs her in a hug as they both collapse in a fit of giggles.

It's a heartwarming picture, and Dancer is grateful to have these precious moments.

Four years ago, her future didn't seem quite as promising. Shortly after Rachel's birth, Dancer became critically ill and was eventually diagnosed with peripartum cardiomyopathy, or congestive heart failure. Although her story ultimately had a happy ending, Dancer has become a passionate advocate for PPCM patients. She takes an aggressive approach to educating medical professionals about this rare yet lethal disease that is often misdiagnosed.

In the United States, PPCM complicates one in every 1,300 to 4,000 deliveries. Although it can occur in childbearing women of any age, it's most common in women older than 30. Typically, the condition is diagnosed during the last month of pregnancy, or within five months after delivery.

After years of trying to become pregnant, Dancer learned in 1998 that her attempt at in vitro fertilization was successful. She and her husband, Jim, eagerly awaited the birth of their first child.

At 29, Dancer was the picture of good health. She swam three miles a day three days a week, exercised regularly, ate healthy foods and maintained a normal weight throughout her pregnancy.

She was happy in her job as a nurse in cardiac critical care, and although she admits to being drawn to patients with congestive heart failure, she had no history of heart disease and had never even heard of PPCM.

Dancer's pregnancy was uneventful until the last six weeks, when she developed edema, gestational diabetes and moderately elevated blood pressure. Her doctor told her they would monitor her closely, and Dancer continued to work full time.

Two weeks before her due date, Dancer gained 11 pounds of fluid in three days. Her doctor took her off work with orders to rest. Because of her diabetes and high blood pressure, doctors decided to induce labor on Dancer's due date.

After an 18-hour labor that culminated in a cesarean, Dancer spent five days in the hospital. When she was discharged, her blood pressure remained slightly elevated.

"I had been home about two nights when I awoke quickly and suddenly," Dancer said. "My heart was pounding at about 130 beats per minute and I was short of breath."

During the next few days, Dancer spent her nights sleeping in a recliner in the nursery. Her symptoms improved during the day, except for a feeling of constant fatigue.

"As a cardiac care nurse, I feel I should have recognized the signs and symptoms of congestive heart failure," Dancer said. "Instead, I took the passive patient role and let my doctor convince me that everything was fine and that I just needed to move around more and not worry so much."

Finally, a week later, Dancer called a physician friend who ran an ECG and saw that it was mildly abnormal. A chest X-ray was ordered and the results showed that Dancer was in congestive heart failure with an enlarged heart and fluid in both lungs. She was prescribed a diuretic and a cardiology appointment was made for the next day.

Dancer still can remember sitting in the exam room and making small talk with her cardiologist.

"I saw the ejection fraction 25 percent to 30 percent on my chart and I remember feeling scared," she said. "I had taken care of patients who were on ventilators with ejection fractions better than that."

Her doctor prescribed rest plus diuretics and an increasing dose of ACE inhibitors and beta blockers. Two months later, her ejection fraction was up to 35 percent and Dancer began cardiac rehab, a patient in the same hospital where she previously worked in critical care and cardiac rehab.

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