In May 2019, Llapitan’s annual mammogram revealed a lump. Her doctors recommended a mastectomy and chemotherapy, but the surgery caused bruising and bleeding, which had to heal before she could begin chemothe­­­rapy.

Llapitan started chemotherapy that September, but something didn’t feel right. At first, she felt like she had a severe cold; soon, she was struggling just to walk a few blocks or climb stairs. By December, Llapitan was fighting to breathe.

Llapitan’s doctor referred her to UW Medicine, where she began seeing April Stempien-Otero, MD, FACC, associate professor of cardiology, cardiology research and medicine. At UW Medicine, patients with heart disease are treated by collaborative teams of specialists from many disciplines to ensure the best possible care; Llapitan’s care team included cardiologists with specializations in heart failure and transplant, cardio-oncology and implantation of support devices.

She spent the holidays in the intensive care unit, and from then on, she would be in and out of the hospital every few weeks — including the day in July 2020 that she’d hoped would be her wedding day. (Llapitan later married her husband, Greg, in a small, pandemic-friendly courthouse ceremony.)

The chemotherapy had caused cardiomyopathy, a disease of the heart muscle that makes it hard for the heart to pump blood to the body. It’s a complication that particularly affects women with underlying heart disease. In Llapitan’s case, a small amount of coronary artery disease, so mild that it hadn’t been diagnosed, may have increased her risk.

In August, Llapitan went back into the cardiac intensive care unit, where her doctors had some devastating news: She had a prognosis of just 12 months. Her only option was a heart transplant, but they were concerned that she was too sick for surgery.

“That was one of the hardest conversations,” says Llapitan. “You’re in fight mode, you survive breast cancer and think you’ll be OK, but it didn’t turn out to be that way.”

Despite the bleak prognosis, Stempien-Otero continued to advocate for Llapitan, presenting Llapitan’s case at the transplant committee’s meetings.

“Janet was determined to get better,” says Stempien-Otero. “I wanted her to know that we were going to work through it together.”

While heart disease is the leading cause of death for both women and men in the U.S., women are dying of heart disease at a faster rate. This is largely because, until now, heart research has focused on male anatomy and the conditions that affect men — meaning that treatments based on that data are less effective for women.

As we learn more about how heart disease impacts women, the need for more gender-specific research and targeted clinical care for women has become clear. And, in turn, improving our understanding of heart disease in women will help lead to better treatments for everyone.

A new Center for Women’s Heart Health would be transformative in significantly reducing heart disease. The center will build upon UW Medicine’s collaborative, team-based approach to patient care. Cardiologists would partner with researchers and clinicians to study how heart failure and coronary artery disease uniquely affect women — and to develop treatments designed for them.

The center would also help improve healthcare equity by bringing inclusive, high-quality care to more women, especially from underserved communities. Updated and expanded clinical spaces, enhanced telemedicine services and culturally responsive care will enable the center to better serve patients.

It’s an ambitious vision. And, says Stempien-Otero, making the Center for Women’s Heart Health a reality will require equally visionary support from the community.

“Donors can help us build a center that delivers the best care, including telemedicine to reach more patients in the WWAMI (Washington, Wyoming, Alaska, Montana and Idaho) region,” says Stempien-Otero. “We can bring in national experts and offer community education. And we can increase the amount of women-specific research, which will ultimately help both men and women.”