For now, doctors are monitoring her closely, hoping that through medications they can strengthen her heart. Last summer, a surgeon placed a defibrillator in her chest, which gives energy to her heart when she needs it.
Today, Pate follows a strict diet and exercises in her living room, using workout tapes. Doctors told her not to return to her job because it involves too much manual labor. She is starting an event-planning business from her home and volunteers at her daughters' school. But she misses her career and her health.
"Some days I feel good, like 'I can do this, I can beat it'," she said. "Other days, I look at my kids and ask, 'Am I going there? Are they going to remember me?' "
Mehra, at the University of Maryland, said researchers are discovering that in addition to commonly known health risks, genetics play a role in how blacks and whites develop heart failure. More research is needed on those differences, he said.
His research has shown that black patients respond differently to medication for heart failure. They tend to need different doses of medication and at different frequencies than whites, he said. And some medicines don't work at all in black patients.
The best prevention for heart failure, however, is to have a healthy lifestyle, Mehra said. Blacks tend to be more sensitive to salt, which is associated with high blood pressure, so it is vital that young African-Americans limit their salt intake. They should also eat healthy foods rich in fish oils and antioxidants - which have been shown in some studies to promote heart health - and exercise regularly, he said.
"The rising tide of adolescent obesity suggests that this is not something that will be addressed in the future. It means we need to redouble our efforts now," said Bibbins-Domingo. "These are the risk factors sitting in our teenagers, particularly our minority teenagers. This is a wake-up call."
