GRADE SCHOOL MIRACLE

Jennifer Jacobsmeyer is in many ways your typical 10-year-old. Slumber parties and singing along with the casts of "High School Musical" and "Hannah Montana" on the Disney Channel are her favorite things in life.

But ask about her heart and her smile disappears, her head drops, and there's a bit of silence as she contemplates how to explain an area of her body that has been pried open three times since she was 3 months old.

It's a difficult subject in the Jacobsmeyer home because they all know how fragile she is, a point that was driven home last month when she had to undergo her third open-heart surgery. Doctors had to replace valves that control the blood flow from her lungs to her heart.

An 8-inch scar runs from Jennifer's breastbone to her abdomen.

"Sometimes I think about it,'' said Jennifer, who lives in Overton, 50 miles northeast of Las Vegas. "I don't know. My classmates used to ask me about what was wrong with my heart and, I don't know, I say it is sick.''

Like most children with heart disease, Jennifer's story is one of courage, inspiration and a strong family backing, according to her pediatric cardiologist, Dr. Ruben Acherman. But her story also should encourage people, Acherman said, especially those with heart problems, to pay attention to signs and symptoms of heart disease. Had it not been for her parents' intuition, Jennifer might not be alive today.

"If you have a heart problem, any symptom you have may be related to the heart,'' Acherman said. "This includes stomach aches, headaches, muscle pain, vomiting or anything. Jennifer's father and mother recognized this.''

Jennifer's parents have had a little bit of practice, though.

Her heart problems were first noticed by her mother, Natalie, when she was just six weeks old.

"Call it intuition, mother love or whatever; I knew something wasn't right,'' Natalie said. "She looked smaller than my other kids at that age; she was thin and pale. She just didn't seem right.''

After a series of tests at Sunrise Children's Hospital, Jennifer was diagnosed with atrioventricular septal defect -- in other words, a hole in the heart. A few weeks later, Jennifer had open-heart surgery.

"Her heart had to work overtime to compensate. The doctor said her condition was like trying to drink a thick milk shake through a straw. That is how hard it was for my little girl to breath,'' said Natalie, who keeps track of Jennifer's medical problems in a three-ring binder.

At the time of her first surgery, Jennifer's parents were told the artificial tissue used to fill in the hole would need to be replaced within eight to 15 years.

That prediction proved true in 2005 when Jennifer underwent open-heart surgery again. This time she went to Stanford's Lucille Packard Children's Hospital in Palo Alto, Calif., where doctors replaced her mitral and tricuspid valves.

In the left heart chamber, the mitral valve controls blood flow into the heart's main pumping chamber, the left ventricle. The valve then closes to keep blood from leaking back into the lungs when the ventricle contracts and pushes blood out to the rest of the body.

The tricuspid valve is on the right side of the heart. Surgery is needed to replace the valves when they don't open or close properly. If not treated, the problem could lead to heart failure, health officials say.

During that surgery, Jennifer also was given a pacemaker to help her failing heart pump blood at a normal pace.

Her pacemaker is placed just underneath the skin near her abdomen area. When she gets older physicians probably will move it to just below her shoulder blade.

For nearly two years after her second surgery, Jennifer's heart worked well with its pacemaker. Routine visits to her pediatrician and cardiologist showed she was also in good health. Then, on Jan. 10, Jennifer's heart began failing again. The signs though, weren't as obvious to her parents as before.

She complained of a stomach ache and was throwing up, said her father, Robert.

"We just thought she might have caught the flu at school because a lot of kids were sick,'' he said. "And we had just taken her in for her checkup because we were getting ready to go on a 7-day family cruise. The heart was healthy.''

Five days later, Jennifer came home from school complaining of a stomach ache. Natalie gave her some Tums and told her to lie down.

The complaints continued so Natalie took Jennifer to her pediatrician in Las Vegas. Her history of cardiac problems prompted a series of tests including blood, urine and a chest X-ray. Except for a small spot on one lung, everything appeared normal, Natalie said.

But Jennifer's problems worsened, and she couldn't seem to go to sleep that night.

Her father, a former paramedic, checked up on her, listening to her breathing. Though her lungs appeared to be clear, he knew something was not right.

"In my years of training, when you think of someone going into heart failure, you immediately think chest pains and numbness in the arm,'' he said. "Those things never came into play in Jennifer's case.''

Even though Jennifer wasn't showing any visible signs of a heart problem, her parents drove her to Sunrise Children's Hospital. They were told in the emergency room that Jennifer's heart was failing again.

"She was a very sick girl. ... Her lungs were basically flooded (with blood),'' Acherman said. "This girl is alive because her family is strong. They acted on their intuitions.

"Not all families are like this.''

For the third time Jennifer underwent open-heart surgery to replace her heart valves.

Today, Jennifer is back to her spunky self, although it will be about a month before she can return to classes at Bowler Elementary School in Logandale.

She has a little bit of a pep to her step, her mother said.

"Who do you think just happened to be visiting Sunrise Children's Hospital after Jennifer had her surgery -- Miley Cyrus,'' Natalie said, holding up a picture of the star of Disney's "Hannah Montana" show hugging Jennifer in her hospital gown.

Contact reporter Annette Wells at awells@reviewjournal.com or (702) 383-0283.