FILE - In this Sunday, Oct. 17, 2004 file photo, Teresa Heinz Kerry covers her heart after speaking at the United Jewish Communities 2004 International Lion of Judah Conference, in Washington. A hospital spokesman says Teresa Heinz Kerry, the wife of U.S. Secretary of State John Kerry, is hospitalized Sunday, July 7, 2013 in critical but stable condition in a hospital on the island of Nantucket, Mass. (AP Photo/Pablo Martinez Monsivais, File) (Pablo Martinez Monsivais/ AP Photo)

Updated, Tuesday 4 p.m.

For a woman who made an unusually vivid impression on the 2004 campaign trail, Teresa Heinz Kerry has been a quieter presence since her husband became secretary of state earlier this year.

And yet, despite a serious health scare just four years ago, the outspoken ketchup heiress has remained a regular on Washington’s social A-list scene, whose denizens were shocked by her hospitalization this weekend. Heinz Kerry, 74, was upgraded from critical to fair condition Monday afternoon after being rushed to Nantucket Cottage Hospital Sunday afternoon. It was a rare public moment for the woman who — at least for the past few years — has preferred to stay in the background. (Update, 7/9: Teresa Heinz Kerry: Condition improves, possible causes ruled out)

For the past five months, she’s solidified her position as one of Kerry most trusted advisers. It’s a role she’s especially suited for: Born in Mozambique, she speaks five languages, worked at the UN and has accompanied Kerry on a few of his diplomatic trips since he took office. Although the couple has been spotted at social events around town — most recently at last month’s Kuwait-America Foundation dinner — she has refused interview requests or comments on world affairs.

But privately, she has enthusiastically embraced her husband’s new job: She recently told friends how proud she is of his service, how well-suited he is for his new assignment, and that she’s okay if she doesn’t see much of him for the next four years because of the work he’s doing — typically wifely praise, but given added weight by her global resume.

It is a marked contrast from her profile during the 2004 presidential campaign, when she was criticized for being too rich, too independent and too opinionated. After her husband returned to the Senate, she quietly pursued her philanthropic work and stayed below the radar until 2009 when she was diagnosed with breast cancer and went public to educate other women and raise money for research.

John Kerry has remained at his wife’s side at Massachusetts General Hospital in Boston. No details have been released about the nature of her condition; several media outlets reports that she was admitted with symptoms consistent with a seizure. She is currently undergoing further evaluation, according to a Kerry spokesman.

Earlier: Teresa Heinz Kerry taken to hospital, 7/7/13

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