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// by Chloe Emory 

Karla Manley remembers soccer coaches in high school telling her parents that she ju

wasn’t athletic. The fatigue she was experiencing was pure lack of talent and stamina

What her parents and coaches didn’t know was that she was pushing herself far hard

she ever should have.

In February 2003, then 33 years old, Manley found herself in the hospital for what w

supposed to be a sinus surgery, when she was informed that the operation was to be

postponed. The doctor had discovered that she had a heart disease.

Although the diagnosis came as a shock to Manley and her family, it saved her life. W

heart condition was congenital, many women with heart diseases suffer the same sym

that can be easily overlooked.

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In fact, until 20 or 30

ago, heart disease was

considered primarily a

affliction and research

focused almost exclus

male subjects. Women

cardiac symptoms wen

largely un-researched

 That, despite the fact

heart disease is the nu

one killer of women,

according to the Amer

Heart Association. It is

deadly for its female vithan all forms of canc

combined.

 Today, however, much more is known about women and heart disease and Manley su

all women should know the signs of impending heart conditions.

“I think a lot of people are just afraid of knowing,” says Manley. So what should wom

know about heart disease?

First, they should know that the rate of death for cardiac disease has actually increas

women 35 to 50 years old in recent years, according to Mayo Clinic cardiologists. Sec

they should know that research over the last decade has shown that women’s sympto

often very different from men’s.

While men often complain of chest pain as their most frequent symptom, women may

instead feel discomfort in the neck, jaw, shoulder, back, or arms as well as experienc

nausea, vomiting or a feeling similar to indigestion.

Because they’re often more subtle, women’s symptoms can be easily overlooked. Man

instance, initially thought her symptoms were attributed to the fact that she was just

shape.

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Locally, Dr. DeLisa Fairweather, director of Translational Cardiovascular Research at

 Jacksonville’s Mayo Clinic, has focused her research on understanding the difference

between men and women when it comes to heart disease.

Fairweather says that the human body’s immune system is regulated differently by s

hormones. Her studies focus on separating her patients into different categories to be

understand how hormones play a part in the disease.

Because of the many differences between the genders, Fairweather explains that a tre

that works for men won’t necessarily work for women.

“Disease diagnosis is different; symptoms are different; pathology is different. We nee

have a different treatment.”

Mayo Clinic suggests women see a doctor if they are experiencing the following sympt

• Neck, jaw, shoulder, upper back or abdominal discomfort• Shortness of breath

• Right arm pain

• Nausea or vomiting

• Sweating

• Lightheadedness or dizziness

• Unusual fatigue

In going forward with her research, Fairweather says her approach is to change the w

patients are treated for the disease. “What we’re really trying to do right out of the ga

going back with data we already have, analyzing it by sex and getting immediate disc

we can apply to patient care, so we can understand key questions going forward.”

Not only do cardiac patients need to be separated by gender for treatments, women a

to be split up into pre- and post-menopause treatment groups, says Fairweather. Thi

to the significant drop in hormones in women after menopause.

Virginia Miller, who leads gender differences research at Mayo Clinic and specializes imenopause affects a women’s susceptibility to heart disease, says “changes in hormo

affect how the heart responds and contracts.”

For example, women battling cardiovascular heart disease do so even more after men

and during pregnancy.

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Dr. Leslie Cooper, chair of the Department of Cardiology at Mayo Clinic, says that, “m

more likely than women to develop myocarditis. When they do, the disease is more se

and the recovery from heart failure less complete.”

Cooper explains that men are more susceptible to heart disease and that their cases

more likely to result in death. “Testosterone and estrogen affect immune cell function

may lead to the changes in heart muscle cells that in turn lead to fatal arrhythmias i

males.”

One of the things that most helped Manley recover was exercise, which experts say is

tremendous help in preventing heart disease. So far, it’s helped her avoid what she be

to be the inevitable: a heart transplant. Nine years after receiving her diagnosis, she

underwent surgery at Mayo Clinic where the leaky valve and hole in her heart were fi

successfully.

“At this point, I don’t know for sure if I’ll ever need a heart transplant,” says Manley.

only been three years since I’ve had the surgery, but I feel 100 percent better.”