Three women from one family are from three generations, but all of them are dealing with the same issue — heart disease.

Helen Knauer, Joanne Heim and Patti Amos — mother, daughter and granddaughter — all have symptoms of hereditary heart disease.

“It’s kind of genetic,” Heim, 81, of Butler said.

Heim said her father died of heart disease as well as her husband. Additionally, her son had a heart attack while he was hunting.

She has an irregular heartbeat, an abdominal aneurysm and is on cholesterol medicine.

Knauer, 98, of Butler said the bottom chambers of her heart are not fully functional. Last year, she had a pacemaker installed.

She suffered a heart attack in June 1976. She was on the golf course, and was taking a lot of Tums, thinking the symptoms were related to heartburn.

“The next day, I knew what it was,” Knauer said.

That was the only heart attack she suffered.

At age 53, Amos also is experiencing some heart symptoms.

All three women see cardiologist Dr. Srinivas Murali at Allegheny General Hospital in Pittsburgh.

Murali said there is no question that cardiovascular disease has a genetic component, and said it is important for patients to know their family histories.

“You can’t change your family risk,” Murali said.

However, he said patients can understand what their risk factors are and work to minimize them. Risk factors can include smoking, inactivity, diabetes and obesity.

Heim said her husband started going to see Murali in the 1980s, and he died in 2011.

“We’ve been going to him a long time,” Heim said.

Amos has had some minor heart symptoms, and her primary care physician advised her to see a cardiologist. While at a visit with her mother and grandmother at Murali’s office, the doctor asked her a few questions. Amos noted that her blood pressure was “all over the place” and her heart rate tends to be high.

“He said, ‘You need to go to the cardiologist,’” Amos said. “I just started with him.”

Amos said her brother was a bit overweight, but was not receiving any treatment.

“He should have been, but I think he thought it wasn’t going to happen, because he was 53,” Amos said.

With all of this history, Amos felt she should begin seeing a cardiologist as well.

“She started going to Dr. Murali, too,” Heim said.

Amos has three children. She said she has made sure that they know of the family’s history with heart disease.

“With my kids, I really tried to make them aware of things,” Amos said. “It could affect them, it’s in their genes.”

A breast cancer survivor, she tells her children to make their doctors aware of conditions that family members have dealt with.

After beginning to see the cardiologist, Amos said she did not have to make any real lifestyle changes. She always has exercised regularly.

“I actually live a pretty healthy lifestyle,” Amos said. “So it kind of caught me off guard.”

She said she always had noticed her heart rate being high.

The women make seeing the doctor a joint venture.

“We always go to the same appointment,” Heim said. “We all go together.”

Heim will drive her mother to Amos’ home in McCandless, and then Amos takes over the driving the rest of the way. Heim’s son used to take them until he died.

“It’s like a family visit,” Murali said.

Murali said they, as a family that has seen the effects of heart disease, have decided to tackle the problem head-on and together.

He said all three women exercise, eat right and take medicine. Additionally, Knauer and Heim remain active for their ages.

Knauer still works part time at the Butler County Courthouse in the clerk of courts office.

“I enjoy it,” Knauer said.

She said she does a lot of work in the file room, organizing papers and placing them on shelves, and also helps get checks out. There are 14 employees in the office, most of whom are young.

“They’re ‘my kids,’ I call them,” Knauer said.

Knauer even drives to work still. The sheriff gave her a parking space just behind the courthouse.

Her daughter said the work helps give Knauer a purpose.

“It keeps her going,” Heim said.

Heim still works full time at the Butler Area Sewer Authority, where she has been an employee for more than 25 years.

“I can’t retire when my mother still is working. That doesn’t look good, does it?” Heim said.

Heim tries to walk regularly, though she takes a break when it snows. She is up at 5 a.m. and gets to work by 7 a.m.

“I have a long day,” Heim said, and said her work really keeps her going.

Knauer tries to get out a lot, often going out to dinner on Wednesday and Thursday evenings, and attends fish fry events at St. Fidelis during Lent.

“I don’t miss too much,” Knauer said.

Amos said Knauer and Heim are a big hit at these events.

“Everyone wants to see her and my mom,” Amos said.