When people meet Marita "Marie" Cruz, one of the first things they notice is her breathy, Marilyn Monroe-like voice.

But until recently, most of her friends didn't realize that sultry tone was caused by a life-threatening condition that now has her on a waiting list for a complete heart and lung transplant.

"Some people knew. My family knew. But only I knew that I was getting worse," Cruz said, in a phone interview from Vacaville, Calif.

In August, 26-year-old Cruz, who grew up in Wahiawa, was medically evacuated to California after complications with her heart and lungs. She was evaluated by doctors at Stanford University Medical Center and later placed on a waiting list to replace her heart and both lungs.

"I'm No. 7 on the list," said Cruz, who now relies on an oxygen tank 24 hours a day. "It depends on finding the right donor match. The doctors say it could take about six months to a year."

Cruz is among a small minority of people who are born with a hole in their heart, a condition known as ventricular septal defect. For many, the condition improves with age — most outgrow the condition by adulthood. But for Cruz, the defect has been a lifelong struggle.

When she was growing up, long walks or other physical activities caused her to over exert. As she grew older, her overstressed heart eventually compromised her lungs, she said.

Major complications in Cruz's condition began earlier this year after she took a vacation to California. Traveling at high altitude had caused her oxygen levels to drop substantially, and she felt her condition was getting worse.

Days later, she said, she began to cough up blood and ended up at the Queen's Medical Center emergency room. She was later told to seek the care of medical specialists at Stanford.

Now in California, Cruz makes weekly visits to three different specialists and lives with her friend Linda Claus in Vacaville, awaiting word on her transplant.

Through all that, Cruz remains emotionally strong. She's even cheerful, making jokes about her daily medication.

"I'm on Viagra. Imagine that," she said.

But the realities of multiple organ transplant always set in.

"Of course I'm scared," she said.

Paying for the procedure is yet another hurdle. The procedure could cost upwards of $600,000, and health insurance will cover only a portion of that cost, she said.

For months after the procedure, Cruz would be required to live closer to Stanford University Medical Center to remain under the watch of doctors.

"I want to live a normal life again," Cruz said. "I want to go back to work. I want to finish my master's degree."

Reach Loren Moreno at lmoreno@honoluluadvertiser.com.