Well

              NOW OPEN!
UNC WELLNESS CENTER
AT NORTHWEST CARY
This new medical fitness facility offers access
to group fitness classes, an indoor track and
more. See page 3 for details.
A Mighty
Heart
Craig Wilkins’ simple
diagnosis requires a
complex solution
WWW.UNCHEALTHCARE.ORG
wellSix steps to a heart-healthy
lifestyle PAGE 4
Treatment at UNC
helps change one
Afghan girl’s life PAGE 6
Researchers work to
make heart disease a
thing of the past PAGE 14
LEADING. TEACHING. CARING. WINTER 2 014
PAGE 10
We Want to Hear from You!
Let us know what you think of Well magazine! Send
your comments or questions to Jennifer Breedlove
at publications@unch.unc.edu.
On the Cover: Photo courtesy of Brian Strickland
Well is published four times annually by UNC Health Care. Copyright 2014 © UNC Health Care.
Contributing writers: Toni Bowerman, Maria Mauriello, Stephanie Soucheray-Grell.
Information in Well comes from a wide range of medical experts and is not intended to treat or diagnose any
individual situation. If you have any concerns or questions about specific content that may affect your health,
please contact your health care provider.
Send correspondence and address changes via: e-mail,
publications@unch.unc.edu; mail, Well, Public Affairs and Marketing,
James T. Hedrick Building, 211 Friday Center Drive, Suite G021, Chapel
Hill, NC 27517; phone, (919) 843-8922; Web, www.unchealthcare.org.
Introducing the UNC
Heart & Vascular Network
This issue of Well is focused on hearT and vascular care
across the UNC Health Care system. I am particularly happy to announce that
we have expanded our system of heart and vascular providers with the new
UNC Heart & Vascular Network.
The new network brings together the former Wake Heart & Vascular
Associates, Rex Heart & Vascular Specialists, and the UNC Center for Heart
& Vascular Care to provide comprehensive, specialized cardiovascular care
throughout central and eastern North Carolina.
In addition to providing access to exceptional care in patients’ local com-munities
where they can have diagnostic and therapeutic procedures, physi-cians
with the UNC Heart & Vascular Network will work together to transfer
patients who need more complicated or specialized procedures.
In this issue, you can read more about how the heart and vascular specialists
at UNC Health Care are sharing resources, using technology and advancing
research to provide care for our communities today and in the future.
In the feature on page 10, we highlight a patient who is an excellent exam-ple
of how the UNC Health Care network of physicians benefits the commu-nity.
Craig Wilkins is a patient whose primary care physician in Cary referred
him to a cardiologist at Rex Hospitals. Eventually, his condition required an
additional advanced procedure, and he was sent to UNC Hospitals in Chapel
Hill. This is the kind of comprehensive, coordinated care that is possible when
physicians join forces.
Sincerely,
Marschall Runge, MD, PhD
Executive Dean, UNC School of Medicine
2 Winter 2014 Well
well WInter 2014
FEATURES
6 Maryam’s Journey
Two UNC cardiac doctors, a UNC
Hospitals volunteer and a nationwide
nonprofit organization changed the life
of one young Afghan girl.
10 Simple Diagnosis—
Complicated Solution
The UNC Center for Heart and
Vascular Care collaborates with
specialists in the Raleigh area to provide
care for the most complex heart cases.
14 Teamwork Guides
UNC’s Cardiovascular
Research
Researchers collaborate to make heart
disease a thing of the past.
17 When Wounds
Won’t Heal
A multispecialty approach means better
outcomes for patients.
DEpARTmEnTS
3 UNC Health Care News
UNC Hospitals and Rex Healthcare
recognized nationally.
4 Community
Tips, services and screenings to help you
get—and stay—healthy.
19 Nutrition
The secrets to eating a heart-healthy diet.
22 Resources
Clinics, services, programs and
screenings to keep your heart healthy.
PERSPECTIVES
UNC Hospitals
Recognized for
Community Value
UNC Hospitals recently was named a top 100 hospital
by Cleverley & Associates in its Community Value
Leadership Awards. Only four North Carolina hospitals
were included on the list, and UNC Hospitals was the
only one in the Triangle.
“At UNC Health Care, we’re proud to support our
community and our state,” says William L. Roper, MD,
MPH, CEO of UNC Health Care. “UNC Hospitals impacts
not only the patients who walk through its doors but our
community as a whole. This designation demonstrates
our commitment to the quality of the care we provide
and to our community.”
For the award, hospitals are evaluated on a variety
of measures that suggest they provide value to the
community. The areas considered are financial viability,
appropriate reinvesting into the facility, maintaining a
low-cost structure, charging a reasonable amount for
services and providing high-quality care for patients.
UNC Hospitals scored in the top 20 percent in all
areas, earning the designation as a Community Value
Five-Star facility.
photo: thinkstoCk
UNC Hospitals and Rex Healthcare were recognized by
U.S.News & World Report in its 2013–14 “Best Hospitals”
rankings.
The annual rankings are considered to be an indicator
of excellent quality and long-standing consistency of care.
Hospitals are ranked in a number of categories, including
top 50 adult and children’s hospitals by specialty; high-performing,
which is the top 25 percent by specialty; and
best hospitals by region.
UnC hospitals and Rex
healthcare Recognized in
‘Best Hospitals’ Rankings
Top 50 by Specialty
UNC Hospitals:
• Cancer (#43)
• Ear, Nose & Throat (#22)
• Gynecology (#44)
N.C. Children’s Hospital:
• Cancer (#31)
• Diabetes & Endocrinology
(#41)
• Gastroenterology &
GI Surgery (#24)
• Neonatology (#28)
• Nephrology (#45)
• Orthopedics (#35)
• Pulmonology (#11)
High-Performing
by Specialty
UNC Hospitals:
• Cardiology & Heart
Surgery
• Diabetes & Endocrinology
• Gastroenterology &
GI Surgery
• Geriatrics
• Nephrology
• Neurology & Neurosurgery
• Pulmonology
• Urology
Rex Healthcare:
• Cardiology & Heart
Surgery
• Diabetes & Endocrinology
• Gastroenterology &
GI Surgery
• Geriatrics
• Nephrology
• Neurology & Neurosurgery
• Orthopedics
• Pulmonology
Regional Recognition
UNC Hospitals is ranked
No. 3 in North Carolina
and is recognized among
the best hospitals in the
Piedmont region. It also is
ranked No. 2 in the Raleigh-
Durham metro area.
Rex Healthcare is ranked
No. 8 in North Carolina
and is recognized among
the best hospitals in the
Piedmont region. It also is
ranked No. 5 in the Raleigh-
Durham metro area.
Now Open: UnC Wellness
Center at northwest Cary
UNC Health Care now has a Wellness Center in
Northwest Cary, in addi-tion
to the Center in
Meadowmont. The new
medical fitness facility is
designed to help people
achieve optimal health
in a safe and supportive
environment.
Membership includes
access to cardiovascular
and strength training
equipment, group fitness classes, complimentary assess-ments,
an aquatics area, a cushioned indoor track, fit-ness
clinics, health education programming and FitLinxx,
which is a computerized training assistant that tracks a
person’s progress.
photo: BRian stRiCkland
Join Today!
The UNC Wellness Center at Northwest Cary
is located at 350 Stonecroft Lane. For more
information, visit www.uncwellness.com or
call (919) 957-5900.
www.unchealthcare.org 3
UNC HEALTH CARE NEWS
Leading a Heart-Healthy
Tips, services and screenings
to help you get—and stay—heart healthy
Heart disease is the No. 1 killer of Americans. By adopting a healthy lifestyle and
eliminating certain risk factors, such as smoking, high blood pressure and high
cholesterol levels, and lack of physical activity, you can reduce your risk of developing
heart disease. To help you get started, UNC Hospitals, Rex Healthcare, and North
Carolina Heart & Vascular offer a number of resources.
1 Kick the Habit
Smokers are two to four times more likely to develop
coronary heart disease than nonsmokers, but people who
quit smoking can decrease their risk by 50 percent after just
one year. UNC Hospitals, Rex Healthcare, and select North
Carolina Heart & Vascular clinics offer smoking cessation pro-grams
to introduce patients to a smoke-free lifestyle and help
them kick the habit. 2 Have It Checked
High blood pressure, also called hypertension, makes
the heart work harder because it must pump with more
force and the arteries must carry blood that is moving under
greater pressure. Most people with high blood pressure have
no warning signs, so it is important to get your blood pres-sure
checked.
The Hypertension Clinic at the UNC Center for Heart
and Vascular Care specializes in difficult-to-treat hypertension.
If you have hypertension that has not responded to treatment,
the Hypertension Clinic may be able to help. 3 Balance It Out
Reducing the amount of “bad” fat in your diet and
increasing the amount of “good” fat are important
components to reducing your cholesterol level and your risk
of heart disease. “Bad” fats include saturated and trans fats typi-cally
found in baked goods, fried foods, whole-fat dairy prod-ucts
and certain meats. “Good” fats include monounsaturated
and polyunsaturated fats found in fish, nuts, seeds and certain
vegetable oils. It is important to remember that fat is fat, so
even when eating “good” fat, eat in moderation.
Lifestyle
PhoTo: PhoToshoT
4 Winter 2014 Well
Community
Cardiac rehabilitation is offered at the UNC Wellness Center at
Meadowmont and the Rex Wellness Centers of Raleigh and Cary.
Photo: Brian Strickland
The UNC Lipid Prevention Clinic, Rex Wellness Centers,
and select North Carolina Heart & Vascular clinics offer cho-lesterol
testing and services tailored to each patient’s needs. 4 Eat Less, Move More
Being overweight increases your chances of having high
cholesterol and high blood pressure levels, and diabetes.
Exercising regularly—just 30 minutes a day—can reduce these
risks and the associated risk of developing heart disease.
UNC Hospitals and Rex Healthcare offer programs to
help you lose weight and keep it off. Weigh to Wellness and
Healthy Way are 12-week, comprehensive weight management
programs that integrate nutrition education with exercise.
Private nutrition counseling, metabolic testing and personal
training are also available through their wellness centers.
North Carolina Heart & Vascular offers heart-healthy eating
information to patients at select clinics. 5 Treat It Right
UNC Hospitals and Rex Healthcare offer comprehen-sive,
outpatient cardiac rehabilitation programs for peo-ple
recovering from surgery, heart attack or heart disease. The
medically supervised programs help patients improve their
cardiovascular health and learn to exercise safely. Individualized
plans include exercise, education, support and counseling to
help patients reduce the risk of future heart problems, feel
better and stronger, reduce stress, and improve overall wellness.
UNC Hospitals Cardiac Rehabilitation program is certi-fied
by both the American Association of Cardiovascular and
Pulmonary Rehabilitation, and the North Carolina Division
of Health Service Regulation. The Bridge to Wellness program
also is available for individuals who benefit from medically
supervised exercise but for whom cardiac rehabilitation is not
recommended by their primary physician.
After completing Rex Healthcare’s Cardiac Rehabilitation
program, patients can continue with Rex Healthcare’s Cardiac
Maintenance Program. 6Dig a Little Deeper
The UNC Center for Heart and Vascular Care offers addi-tional
specialized services to ensure your heart is healthy.
Cardiac Genetics: Certain cardiovascular diseases are
known to have a genetic component that makes them likely to
be passed down from one generation to the next. In such cases,
it may be beneficial to receive genetic testing and counseling.
Men’s Health: A link has been discovered between some
cases of erectile dysfunction (ED) and heart disease. Specialists
in urology and cardiology at UNC Hospitals collaborate to treat
patients who are affected by both conditions.
Women’s Health: Heart disease is the leading cause of
death in women in the United States. The Women’s Heart
Program at UNC Hospitals seeks to educate, identify and treat
women of all ages who are at risk.
Get Screened
Heart disease can largely be predicted and
prevented, so it is important to know your risk fac-tors.
Rex Healthcare promotes early detection and
education by offering 10 simple, routine health
screenings in the Raleigh community. Rex Healthcare
also offers these screenings through its mobile
service to companies throughout the Raleigh area.
Screenings include:
• Abdominal aortic aneurysm
• Blood pressure
• Body mass index (BMI) and waist circumference
• Cardiac ejection fraction
• Cholesterol
• Blood glucose
• Pulmonary function
• Sleep disorders
• Stroke/carotid artery
• Gastric reflux
For a list of heart and vascular resources at UNC
Hospitals, Rex Healthcare, and North Carolina
Heart & Vascular, see page 22.
Sources: The American Heart Association and
the Centers for Disease Control and Prevention
www.unchealthcare.org 5
Photo: NathaN CleNdeNiN
Maryam’s Journey
6 Winter 2014 Well
Two UNC cardiac doctors, a UNC Hospitals volunteer
and a nationwide nonprofi t organization changed
the life of one young Afghan girl.
BY TONI BOWERMAN
ON JUNE 21, 2013, six children arrived at Raleigh-Durham
International Airport. Having journeyed around the world
from their homes in Afghanistan, these brave young people met
for the   rst time with their American host families. Exhausted
and frightened, they moved forward into a country where they
were promised they would receive medical aid. One of those
children was Maryam, an 8-year-old with a congenital heart
defect destined for treatment at UNC Hospitals. Maryam came to the United States through Solace
for the Children, a nationwide nonpro  t organization that arranges visits for children from war-torn
countries who need medical treatment they cannot receive in their home countries. “We had initially
only planned to bring   ve children this summer,” says Bart Clark, president and branch coordinator of
the Southern Pines branch. However, one determined volunteer at UNC Hospitals was able to provide
the funding for Maryam, and the organizers at Solace for the Children Southern Pines found a last-minute
host family for her. >
Maryam’s Journey
{last- minute { www.unchealthcare.org 7
her defect as a patent ductus arteriosus,
or PDA. The ductus arteriosus is a blood
vessel that connects two main arteries in
the heart. Usually, the PDA closes within
a few days after birth. However, in rare
cases, the PDA does not close, resulting in
increased blood flow to the lungs and, if
left untreated, heart failure.
“Most of the time, babies in the United
States with a PDA are recognized in the
newborn period or in their first months of life and then have
surgery at that time,” says Dr. Frantz. “Had Maryam’s condition
continued to go untreated, it would have eventually resulted
in high blood pressure and heart failure on the left side of
her heart.”
Dr. Frantz initially expected to be able to close Maryam’s
PDA through a procedure at the Pediatric Cardiac
Catheterization Laboratory at N.C. Children’s Hospital.
This procedure involves threading a catheter through a vein
in the leg and into the heart. Once in the heart, the catheter
is used to place a small plug in the opening of the ductus.
Over time, the body forms a natural tissue over the plug.
During the procedure, Dr. Frantz discovered a second con-dition
that needed to be corrected—a coarctation of the aorta.
“Essentially, she had a narrowing in the aorta, which is
the main blood vessel that carries blood to the body,” says
Dr. Frantz. “The coarctation and the PDA were right next to
each other, and part of the reason it wasn’t recognized earlier
Elman Frantz,
MD
Photo: Paul Braly,
tarheel Images
Paving the Way
Rita Bigham and her dog, Pippin, have been volunteer-ing
at UNC Hospitals for 14 years. A former elementary
school teacher, Bigham says she was really inspired when
she learned about Solace for the Children.
“Some of these children have major medical problems,
but there’s just not the medical expertise in Afghanistan
to help them,” says Bigham. She and her husband, Eric,
established a fund to cover the medical expenses related
to Maryam’s treatment. “The whole community has really
rallied around this child,” says Bigham.
An Unexpected Detour
The first UNC physician to work with Maryam was Elman
Frantz, MD, chief of pediatric cardiology, who identified
Maryam having a
little fun before her
surgery on July 9.
Photo: KatIe o’BrIeN
“had maryam’s condition continued
to go untreated, it would have
eventually resulted in high blood
pressure and heart failure on the left
side of her heart.”
elman Frantz, md, chief of pediatric cardiology.
8 Winter 2014 Well
was the blood   ow through the PDA, or the ductus, was
somewhat disguising the coarctation.”
After discovering the coarctation, Dr. Frantz decided to
forgo the catheter procedure in favor of surgery.
“Some catheter procedures can be done for a coarctation,
but they require close follow-up and possibly further proce-dures.
We felt that she would not receive the necessary follow-up,
and so I think the surgical procedure was better for her,”
he says. Maryam’s case was turned over to UNC Hospitals
Director of Pediatric Cardiac Surgery Michael Mill, MD.
On July 9, Dr. Mill performed heart surgery on Maryam.
Coarctations of the aorta frequently appear directly oppo-site
of a PDA, and the presence of the open PDA creates
an excessive   ow of blood which can lessen the symptoms
that would otherwise accompany such
a narrowing, explains Dr. Mill. During
surgery, he removed the narrowed sec-tion
of the aorta, sewed o  the end of
the ductus, and then sewed the aorta back
together, metaphorically killing two birds
with one surgical stone.
“One of the side e  ects of getting rid
of a coarctation is that the organs in the
abdomen are seeing more blood   ow
than they’re used to, particularly the kid-neys,”
says Dr. Mill. “The kidneys tend to secrete hormones
that make the kids hypertensive, so it’s not uncommon for
kids to have high blood pressure after these operations.”
Maryam stayed in the hospital for eight days following her
surgery while her blood pressure was regulated.
“Maryam is doing great,” says Dr. Mill. “She’s still young
enough that she ought to be able to adapt, so I don’t think
she’ll end up on any blood pressure medications long term.”
Michael
Mill, MD
PHOTO: BRIAN STRICKLAND
UNC Project-Uganda
UNC Project-Uganda was founded in 2008 as part
of the Amal Murarka International Pediatric Health
Foundation, a foundation established in memory
of UNC physician Amal Murarka, MD.
“Our goal in setting up Project-Uganda was to
work with the Uganda Heart Institute and Mulago
Hospital, which is the largest hospital in Uganda,
to develop a sustainable cardiac surgery program,
and so we’re not only going over there to try to
help those kids but also to help train their entire
staff to be able to do it after we are gone,” says
Dr. Mill, who has been on two of Project-Uganda’s
three trips to Kampala, the capital.
Since 2004, the Amal Murarka International
Pediatric Health Foundation has partnered
with Mulago Hospital at Makerere University in
Kampala, Uganda. This partnership has not only
established a pediatric cardiac intensive care
unit but has also provided cardiac surgery to
30 Ugandan children who might otherwise have
lost their lives.
For more information about UNC Project-
Uganda and similar programs, visit www.global
health.unc.edu/programs/africa.
After her six-week stay in the United States, Maryam
returned to Afghanistan on Aug. 3 with a healthy heart and
no signs that she will have complications.
“It’s always very gratifying to be able to do something for
someone who wouldn’t otherwise be able to receive care,” says
Dr. Frantz. “I’m always happy to do this sort of thing.”
Maryam, right,
on the playground
with her heart
sister Hannah
Saye of Pinehurst.
PHOTO: NATHAN CLENDENIN www.unchealthcare.org 9
The UNC Center for Heart and Vascular Care
collaborates with specialists in the Raleigh area to
provide care for the most complex heart cases.
By STepHaNie SoUCHeRay-GRell
Simple Diagnosis—
CompliCateD Solution
“He said my heart was beating a mile a minute,” says
Craig. “That’s why I was so tired. My heart was wearing
me out.”
An estimated 12 million people will have atrial fibril­lation
by 2050, according to the Centers for Disease
Control and Prevention. Atrial fibrillation is a type of
arrhythmia that causes the heart to beat irregularly. It can
be genetic or caused by scar tissue on the heart, diabe­tes,
high blood pressure or stress. An aging population,
an increased survival rate following heart attacks and ris­ing
rates of heart disease mean more Americans will be
entering their 60s and 70s with arrhythmias, which are
a leading cause of stroke and cardiac events, and can dra­matically
alter a person’s quality of life.
For some, atrial fibrillation is annoying but not life
threatening. For Craig, the condition had gone undetected
for so long that he had developed congestive heart failure.
“I was shocked when the doctor told me how serious it
was,” says Craig.
Initially, Craig was given a course of blood thinners to
prevent clots that could be lethal, followed by a cardio­version,
an electrical shock to the heart, to reset the heart­beat
back to normal. Though this worked initially, his
heart eventually returned to the abnormal heartbeat. After
several attempts at cardioversion, Craig’s doctor tried anti­arrhythmia
medication.
“They put me in the hospital and used a powerful anti­arrhythmia
drug,” says Craig, who stayed in the hospital
for three days as doctors watched his heart. Two days after
he was released, he returned to work and passed out at
his desk.
“Two days out of the hospital and my heart not only
went out of rhythm but went into a life­threatening
rhythm, and I passed out cold at my desk. I came around
as my co­workers
were reading the instructions on the
defibrillator paddles.”
Because his heart kept falling out of rhythm despite
several attempts to regulate it with electric shock and
Craig Wilkins was feeling tired, breathless and in need of a vacation. Although he
attributed his tiredness to too many long and hectic hours at the office, the 56­year­old
decided to see his family doctor in Cary, N.C., before leaving for a family trip.
Craig was otherwise healthy and had no history of heart disease, but his doctor
discovered he had atrial fibrillation, a condition that can cause the heart to race, sometimes
beating hundreds of times in one minute. These episodes, called tachycardias, were making
Craig feel fatigued.
10 Winter 2014 Well
Atrial fibrillation is
a thing of the past
for Craig Wilkins,
who is feeling well
after undergoing
the Convergent
Procedure.
Photo: Brian Strickland www.unchealthcare.org 11
medications, Craig’s cardiologist referred him to Paul Mounsey,
MD, FACC, director of electrophysiology at UNC Hospitals.
Working Together
to Provide Top-Notch Care
UNC Health Care is on the cutting edge of treating complex
arrhythmias. Now, specialists from Wake Heart & Vascular
Associates, Rex Heart & Vascular Specialists, and the UNC
Center for Heart and Vascular Care are joining to create the
UNC Heart & Vascular Network.
“We are going to establish a network in Raleigh that
enables patients and physicians to work together in Wake
County for patients who have difficult-to-treat arrhythmias,”
says Andy Kiser, MD, chief of the Division of Cardiothoracic
Surgery. “This is a collaborative effort
between the best doctors in the region.
Our idea is to bring the service closer to
the people so patients don’t have to travel
so far to find collaborative care.”
Dr. Mounsey says opening the UNC
Heart & Vascular Network will help
many patients remove the barriers that
block their access to the best care for
their conditions.
“Half of our patients come from Wake
County,” says Dr. Mounsey, “and many
patients—both new and referrals—have
to make a 60-mile round-trip drive to
see us in Chapel Hill. What we’re look-ing
for in the new network is to offer our
services of highly complex procedures.
Arrhythmias are a public health issue,
and we’re seeing more patients in need
of these services every year.”
Complex Solutions for
Complex Arrhythmias
Treatment for arrhythmias typically
includes medication called beta blockers,
which help slow the heart down, or pacemakers, which are
small implanted devices that keep the heart’s rhythm reg-ulated
with small electric shocks to the heart. For patients
like Craig whose arrhythmia was not corrected with initial
treatment options, surgery may be necessary to reset the
heart’s rhythm.
Dr. Mounsey performed a cardiac ablation on Craig’s
heart. In an ablation, doctors thread catheters through the
arteries to the heart and use radiofrequency to destroy the
damaged heart tissue causing the atrial fibrillation. Ablations
are often successful, but in Craig’s case, a flutter continued
even after the procedure. A second ablation was performed,
but the location of where the flutter was originating meant
ablation could not correct it.
Dr. Mounsey then collaborated with Dr. Kiser to perform
the Convergent Procedure.
Traditionally, surgeons, like Dr. Kiser, have created scar pat-terns
to disrupt the circuitry that causes atrial fibrillation
arrhythmia, while electrophysiologists, like Dr. Mounsey,
have performed ablations. With the Convergent Procedure,
Drs. Mounsey and Kiser work side by side using minia-ture
cameras, small catheters and electrodes to map out an
individualized pattern that will work to reestablish normal
rhythms in each patient.
Drs. Mounsey and Kiser have been performing the pro-cedure
since 2011, and they recently completed their 100th
surgery. They have an 80 percent success rate, which is
extremely high for complex arrhythmias.
Five years after Craig’s initial atrial fibrillation diagnosis
and a year and a half after having the Convergent Procedure,
he says his health is excellent. “I can’t believe how bad I
Know Your Risk
Rex Healthcare offers HeartAware, an online
evaluation tool for heart disease.
Answer a few simple questions, and HeartAware
will provide you with a report of your risk factors
and recommendations for improving and main-taining
a healthy lifestyle—and it only takes about
seven minutes.
If the evaluation shows you are at risk, Rex
Healthcare offers free follow-up screenings and
consultations to help you decide the best way
to proceed.
Go to www.rexhealth.com/heart-aware to get
your free evaluation today.
Andy Kiser, MD (left), with Paul
Mounsey, MD, FACC
Photo: Donn Young
12 Winter 2014 Well
Symptoms
of Atrial Fibrillation
Atrial fibrillation (AF) is an irregular heartbeat
that can lead to blood clots, stroke, heart failure
and other heart-related complications. Some
people with AF have no symptoms while others
may experience one or more of the following
symptoms:
• Rapid and irregular heartbeat
• Fluttering or “thumping” in the chest
• Dizziness
• Shortness of breath and anxiety
• Weakness
• Faintness or confusion
• Fatigue when exercising
• Sweating
• Chest pain or pressure
Source: American Heart Association
used to feel,” says Craig. “I have energy and a desire to do
things now.”
Craig felt so good, he left his IT job behind and made
a career change, opening The Meat House, a neighborhood
butcher and grocery franchise in Raleigh and Cary.
A Coordinated Effort
Craig’s case is a good example of the patients who will
benefit most from the UNC Heart & Vascular Network.
Patients who live in the Raleigh area and their primary care
physicians will have access to a group of cardiologists and
services in their local communities, and for the most com-plex
cases, they will have access
to the leading research, technol-ogy
and specialty care available at
UNC Health Care.
With the creation of this new
network, Drs. Kiser and Mounsey
will work alongside Sidharth Shah,
MD, a cardiac electrophysiologist
in Raleigh. Dr. Shah performs
cardiac ablations and works with
cardiac devices, such as pacemak-ers
and cardio defibrillators, and his
work is closely associated with research opportunities and
clinical trials.
“In the past we had to send our patients who were in the
UNC or Rex system to other centers,” says Dr. Shah. “Now,
we can keep them close to home.”
Sidharth Shah, MD
Photo: Brian Strickland
Photo: Bryan regan
Welcome, Dr. Gilliam
Francis Roosevelt Gilliam III, MD, joined UNC Health Care
in September, bringing with him more than 25 years of
experience in the field of electro-physiology.
His focus is cardiac
device implantation and pro-gramming,
as well as the remote
management of these devices.
Dr. Gilliam earned his medical
degree from the Duke University
School of Medicine before
completing his residency in
internal medicine and a fellow-ship
in cardiovascular disease
at Duke University Medical
Center (DUMC). Dr. Gilliam then
joined the faculty at Duke in the
Department of Medicine focusing on the development of
the school’s pacemaker program.
In 1989, Dr. Gilliam established Richmond’s first elec-trophysiology
program outside of the university setting
at Chippenham Medical Center in Virginia. Success in the
private sector encouraged him to continue pursuing more
efficient and effective ways to manage implanted cardiac
rhythm devices, such as pacemakers and implantable car-dioverter
defibrillators. These efforts led Dr. Gilliam back
to DUMC as chief of the electrophysiology program.
In 2006, Dr. Gilliam left Duke to spearhead a full-service
electrophysiology program in Jonesboro, Ark.,
at St. Bernards Medical Center acting as the program’s
medical director.
Francis Roosevelt
Gilliam III, MD Photo: Paul Braly, tarheel imageS
www.unchealthcare.org 13
Researchers work to
make heart disease a
thing of the past.
By MaRia J. MauRiello Cardiovascular disease affects the body’s
heart and blood vessels and is the
No. 1 cause of death in the United States.
Researchers at UNC Health Care are
diligently working to change that statis-tic
by advancing the medical care doctors
can offer their patients. “UNC’s efforts
in cardiovascular research are driven by
the needs of the patients our physicians see every day,” says Marschall
Runge, MD, PhD, executive dean of the UNC School of Medicine.
“As national and international leaders in this arena, our investigators
are breaking new ground and discovering better, more effective pre-vention
and treatment options to improve the lives and life expec-tancies
of people in North Carolina and around the world.”
Photo: BRian StRickland
Collaboration Guides
UNC’s Cardiovascular
Research
14 Winter 2014 Well
UNC Health Care attracts some of the most talented
international researchers, says Dr. Runge. “We believe there
is great value to our patients when we optimize clinical care-based
research, and we strive to do so across the spectrum
of cardiovascular research. This is necessary for top-flight
research and is tremendously valued by investigators. Very
few institutions even have the possibility of this level of col-laboration,
much less the reality of it that we do here. It is
part of what is unique and powerful about UNC.”
The information that researchers and doctors exchange
through that open-door policy shapes most, if not all,
of the clinical trials and research at UNC. Also, patients
become part of the collaborative team by participating in
research trials, which helps future patients receive the best
possible care.
UNC’s cardiovascular researchers are working to combat
three common health issues: atherosclerosis, thrombosis and
wound healing.
Atherosclerosis
At the age of 60, Barbara was doing everything she knew
to stay healthy. She exercised by walking daily and partici-pating
in marathons and triathlons. She ate a well-balanced
diet and did not smoke or drink alcohol.
Despite her healthy lifestyle, Barbara realized during a visit
with her mother in New York that something was wrong. She
was having increased difficulty breathing after her daily walks,
which then became crushing pain in her back and chest.
“I knew I needed to see my doctor,” the former health
educator says.
Back home in North Carolina, Barbara’s family doc-tor
ordered blood work and a chest X-ray. She was then
referred to a cardiologist who told her she had an abnormal
electrocardiogram reading and an unexplained “blip” on a
stress echocardiograph.
After her cardiologist recommended she have cardiac
catheterization, Barbara was offered the option of participat-ing
in a clinical trial being led by James Zidar, MD, clinical
professor of medicine at the UNC School of Medicine and
chief of cardiology at Rex Healthcare. The ABSORB trial is
one of several clinical trials Dr. Zidar is leading that explore
new methods for unblocking clogged arteries. It compares
the effectiveness of current metal stents
to the Bioresorbable Vascular Scaffold
(BVS), which is a new device that opens
the clogged artery and is then absorbed
by the body after the artery has healed.
“It is a privilege and an honor to be
among the few in the U.S. involved in
this study,” Dr. Zidar says. “Most patients
do not want a permanent metal implant,
and this is the first technology that does
its job and goes away. It is the ultimate solution.”
“Dr. Zidar gave me a lot of information about the trial and
was very reassuring, answering all my questions,” Barbara says.
During her catheterization, doctors discovered that one of
Barbara’s major arteries was more than 99 percent blocked.
James Zidar, MD
Photo: Brian Strickland
“I was in shock. I have low blood pressure, no family history
of heart disease, and I’ve always taken good care of myself.
I never saw this coming.”
The kind of blockage Barbara had is known as athero-sclerosis,
which occurs when deposits of fat, cholesterol and
other substances, known as plaque, accumulate on the arterial
walls. Eventually, the plaque blocks blood flow to and from
the heart and can lead to a heart attack or stroke.
About half of the more than 2 million stents implanted
worldwide each year to clear blocked arteries are done in the
United States.
Although she does not know if she received the tradi-tional
stent or the BVS, Barbara says she feels great and is
very grateful.
“Medicine is an evolving science, and if my participation
in the trial will benefit other patients, I feel that I have also
contributed something positive to that process.”
The ABSORB trial is just one example of the collabora-tive
research being done at UNC Health Care. Several UNC
trials are searching for new and improved ways to maintain
normal blood flow with atherectomy. This minimally invasive
procedure offers a better healing process for patients who
are 60 years or older with blockages in the legs, pelvis or
carotid artery.
The EXCEL trial is following 2,500 patients who
underwent coronary artery bypass graft surgery or drug-eluting
stenting to correct multiple arterial blockages.
“We will monitor these individuals for five years to note
which procedure was most effective, and the data we collect
will be invaluable in treating future patients of this type,”
Dr. Zidar adds.
Wound Healing
In April 2011, Jessica Riley scratched an itch on her leg. The
consequences of that simple action would send her on a year-long
medical journey she never imagined.
Jessica has a blood disorder that causes blood clots, poor
circulation in her legs and swelling in her feet. Overnight, the
“Very few institutions even
have the possibility of this level
of collaboration, much less the
reality of it that we do here. it
is part of what is unique and
powerful about Unc.”
Marschall runge, Md, Phd, executive dean of the
Unc School of Medicine.
www.unchealthcare.org 15
small scratches her   ngernails left on her right leg and left
ankle became huge wounds called venous leg ulcers because
of her impaired circulation. The ulcers became in  amed
and infected and were unable to heal.
The 27-year-old Snow Camp
resident’s local physician referred
her to William Marston, MD,
medical director of the Wound
Healing and Podiatry Clinic in
the UNC Center for Heart and
Vascular Care.
For more than a year,
Dr. Marston saw Jessica weekly
while she maintained a daily
regimen of bandage changes
and topical cream treatment.
The wounds would initially
shrink but would always get
worse again.
Jessica’s nonhealing wounds made her an excellent can-didate
for a clinical trial being led by Dr. Marston to test a
unique living stem cell formula for treating chronic venous
leg ulcers. “I had no worries about entering the study,”
Jessica says. ”Nothing was working, and I was willing to
try anything.”
“When applied to a patient’s skin, the stem cells release
proteins and signal pathways that tell the wound to heal
itself,” Dr. Marston explains. The nonsurgical procedure is
noninvasive, which is easier on the patient.
Within one week of receiving her   rst
treatment in the trial, Jessica’s wounds
dramatically improved. After seven weeks,
the wounds had closed and were heal-ing
well.
Although she does not know if she
received the medication or the placebo
in the study, Jessica has no regrets. “If you
have a chance to enter a research study,
do it,” she says. “I had never heard of
research studies like this, and I thought it
was worth trying since I had nothing to lose.”
Conditions like Jessica’s are not uncommon, and research-ers
at UNC Health Care are determined to improve the lives
of those su  ering from them. Many chronic diseases, such
as atherosclerosis, diabetes, rheumatoid arthritis and lupus,
ultimately can result in wounds that the body is unable to
heal on its own.
“Oftentimes, the severity of these wounds supersedes
the patient’s primary health issue and prevents a full recov-ery,”
Dr. Marston notes. “In the past, many of these wounds
required months of treatment to heal, but now UNC is
entering a new frontier, using stem cells to repair damaged,
unhealed wounds, which will hopefully lead to accelerated
wound closure.”
Thrombosis
Thrombosis occurs when a blood clot forms within a blood
vessel, blocking blood   ow through the circulatory system.
“UNC’s continued research through the Hemophilia and
Thrombosis Center is helping hemophiliacs live longer and
improving the treatment of people with blood clots in their
lungs,” Dr. Runge notes.
Dr. Nigel Mackman is director of UNC’s McAllister
Heart Institute. Fifty research labs are a  liated with the
Institute that study the causes, treatment and prevention of
arthrosclerosis and thrombosis, and ways to reprogram the
heart muscle to restore its function after a heart attack. “We
want to understand the processes so we can focus on preven-tion,”
he says. In addition, research into new drug therapies
for thrombosis may reveal which medicines are safer for use
long term in patients.
“By putting patient care   rst and creating a collaborative
environment to continuously improve that care, the cardio-vascular
researchers at UNC are making innovative inroads
to signi  cantly impact people’s health and well-being,”
says Dr. Runge. “As an academic medical center, UNC is
uniquely equipped to seek and   nd the best health care
solutions for our patients today, tomorrow and for many
years to come.”
William
Marston, MD
PHOTO: BRIAN STRICKLAND
16 Winter 2014 Well
PHOTO: LAURA MELEGA
Jessica Riley
James Zidar, MD, checks the heartbeat of one of his patients.
PHOTO: BRIAN STRICKLAND
When Wounds
A multispecialty approach
means better outcomes for patients.
Vascular disease can have life-threatening complications, as well as life-altering
results. Vascular specialists work with physicians in other specialty areas to
care for patients with conditions such as peripheral arterial disease (PAD) and
diabetes, which can lead to nonhealing wounds and, in severe cases, ampu-tation.
UNC Health Care, including UNC Hospitals and Rex Healthcare,
is at the leading edge of vascular procedures, focusing on the most conservative and
least-invasive treatment options. With the latest technologies available and some of the
country’s most renowned specialists on staff, the vascular team is recognized nationally
for its successful patient care. >
Heal
Won’t
www.unchealthcare.org 17
Preventive Care Saves Limbs
In the last decade, the number of amputations in
North Carolina has decreased by 20 to 25 percent.
One reason for the decline is that health care profes-sionals
are focusing more on preventive care.
“Many of the underlying conditions leading to
amputation can be prevented or treated successfully,”
says William Marston, MD, chief of vascular surgery
and medical director of the UNC Wound Healing and
Podiatry Center. “The most important thing is to man-age
these medical conditions as well as possible with
your primary care provider. If you have diabetes, work
with your primary doctor, nutritionist and other spe-cialists
to manage your condition. Good control can
prevent the development of complications like nerve
dysfunction that can increase the risk of limb loss.”
Even with preventive care, some patients will
experience complications that need to be treated by
a wound care or vascular specialist. If you are expe-riencing
pain and tiredness in the leg while walking
or numbness in your hands and feet, or if you have
a wound that does not heal quickly on its own, you
should seek medical help and make an appointment
with your primary care physician. Do not try to fi x
the problem on your own.
Get Healing Help
For more information about the UNC Wound
Healing and Podiatry Center, and the Rex Wound
Healing Center, visit www.unchealthcare.org/
site/woundmanagement, www.rexhealth.com/
wound-healing, www.ncheartvascular.com and
www.rexvascular.com.
UNC Hospitals and Rex Healthcare
have the same multispecialty approach
when it comes to treating patients at risk
for amputation and are working toward
the same goal, which is limb preserva-tion,
says William Marston, MD, chief
of vascular surgery and medical direc-tor
of the UNC Wound Healing and
Podiatry Center.
“Both hospitals involve wound, vas-cular,
podiatry and diabetes specialists.
You need this sort of team to give opti-mal
care to the patient. There is a lot of
expertise that di  erent specialists bring
to the table, and we are coordinating that
so patients can come to one place and
get the care they need,” says Dr. Marston.
“Both UNC and Rex have dedicated
vascular teams trained in the latest inter-ventional
and surgical procedures to
minimize the risk of limb loss. We try
to do what is most convenient for the patient by o  ering
experienced teams at both hospitals.”
A Rare Procedure
Addresses an Unmet Need
For many people, severe arterial blockage in their legs ulti-mately
leads to amputation. “In the most extreme cases—
those who have ulcers that won’t heal or have pain while at
rest—25 percent will have an amputation within one year,”
says Rex Healthcare cardiologist George Adams, MD, MHS,
who is pioneering a new treatment to help people in danger
of amputation because of complications from PAD. The pro-cedure
helps restore blood   ow to threatened limbs when
conventional treatment has failed.
“We have about an 80 percent salvage rate in terms of
preventing limb loss,” Dr. Adams adds. “Of those who have
an amputation, 40 percent will die within two years. So
amputation prevention is a huge unmet need.”
One conventional approach to treat the blockage is per-forming
an angiogram through the groin. However, this
route may not be practical for patients who have ulcers
below the knee or that are otherwise inaccessible.
In those cases, Dr. Adams uses another access point to
approach the blockage from a di  erent direction, through
the small vessels on the top or the side of the foot, or at
the back of the knee. He is one of only a few physicians
in the country who perform this innovative endovascu-lar
procedure.
“We are constantly looking for new technologies and
treatments that will improve the potential to salvage limbs,”
says Dr. Marston. “Clinical trials are so important to this
e  ort. In our clinic, our focus is on the wound and the
patient. If a wound cannot be healed, we want to make sure
the patient has the right tools to deal with their prognosis
and has the best quality of life.”
“Both hospitals involve wound,
vascular, podiatry and diabetes
specialists. You need this sort of team
to give optimal care to the patient.
There is a lot of expertise that different
specialists bring to the table, and we
are coordinating that so patients can
come to one place and get
the care they need.”
William Marston, MD, chief of vascular surgery
and medical director of the UNC Wound
Healing and Podiatry Center.
William
Marston, MD
PHOTO: BRIAN STRICKLAND
George Adams,
MD, MHS
PHOTO: BRIAN STRICKLAND
18 Winter 2014 Well
A Two-Pronged Approach
to Heart-Healthy Eating
Lowering your blood pressure and improving
your cholesterol levels could save your life.
By Toni Bowerman
The American mantra for
heart health has always
been a simple one. Diet and
exercise; rinse and repeat.
But what kind of diet keeps
your heart functioning at its most effec-tive
level? UNC outpatient nutritionist
Susannah Southern, RD, LDN, recom-mends
a two-pronged approach to help
lower your blood pressure and improve
your cholesterol levels.
“I usually get referrals when a patient
has elevated fasting cholesterol levels, or
when a patient’s blood pressure is high
and they request a nutrition referral from
their doctor,” says Southern.
When a patient is referred to the out-patient
nutrition office, they have an ini-tial
visit to compare their current eating
habits with heart-healthy recommenda-tions.
Southern also explains to patients
how eating habits can affect blood pres-sure
and cholesterol levels. Then together,
they construct a new dietary approach.
Step 1: Slash the Salt
The most significant dietary contributor
to high blood pressure is excessive sodium
intake, according to the Dietary Guidelines for
Americans from the Department of Health
and Human Services and the Department
of Agriculture. People who are not at risk
for cardiovascular disease should con-sume
no more than 2,300 milligrams
(mg) of sodium a day, while those who
are at risk should reduce their sodium
intake to less than 1,500 mg per day.
NutritioN
Many cardiac patients who are admit-ted
to the hospital are not aware of how
much sodium they consume. UNC inpa-tient
cardiac nutritionist Ashley Smith,
RD, LDN, says she frequently meets
with patients who are surprised to learn
that they will be placed on a sodium-restricted
diet.
The majority of sodium in the
American diet is added during pro-cessing,
not during cooking or at the
table, says Smith. This makes it incred-ibly
important to always read nutrition
labels and to choose low-sodium options
whenever possible.
Step 2: Cut the Bad Fats
Southern also advises her patients to
replace saturated and trans fats with
healthier ones from olive oil, nuts, avo-cado
and fish. Limiting saturated fat helps
reduce dietary cholesterol, as well, since
many foods high in saturated fats are usu-ally
the main sources of cholesterol. In
the human body, low-density lipoprotein,
or LDL cholesterol, builds up in arteries,
forming deposits that restrict blood from
passing through. Dietary cholesterol is
primarily found in animal products, such
as eggs and beef. Those who are at risk for
cardiovascular disease should consume no
more than 12 to 17 grams per day.
Putting heart-healthy eating into
practice can be difficult. Southern often
recommends using a food journal, which
makes it easier to add up the numbers
and adds accountability.
In addition, Southern often refers her
patients to the Dietary Approaches to
Stop Hypertension (DASH) diet, devel-oped
by the National Heart, Lung and
Blood Institute. The DASH plan encour-ages
abundant consumption of fruits,
vegetables, seafood, poultry, whole grains
and nuts, while curbing red and pro-cessed
meats, as well as foods containing
excess sugar or salt.
Low-density lipoprotein,
or LDL, is known as
“bad” cholesterol. High-density
lipoprotein, or
HDL, is known as “good”
cholesterol. Together,
they are part of your total
cholesterol count.
pHoTo: THinksTock
www.unchealthcare.org 19
Learning to Eat
for Your Heart Health
How can you adopt a heart-friendly diet for good?
Start slowly.
By Toni Bowerman UNC Hospitals is testing an innovative
nutrition program to educate cardiac
patients. The program, which includes a
team of nutritionists, nurses and physicians,
is designed to slowly transition patients to
a heart-healthy, low-sodium, low-fat diet during a period of
several weeks.
Typically, patients who are admitted to the hospital with
heart conditions are put on a strict low-sodium, low-fat meal
plan. The cold-turkey transition is easily managed while
the patient is in the hospital and under the supervision of
medical professionals but rarely leads to long-term dietary
changes once the patient goes home, says Barbara Lusk, RD,
LDN, associate director of nutrition and food services at
UNC Hospitals.
Patients at UNC Hospitals have access to a restaurant
delivery system that allows them to order food from UNC
Nutrition & Food Services 24 hours a day. A menu is pro-vided
with more than 94 different entrees, including items
that are identified as heart-healthy selections.
“Before when a patient called to order a meal, the tech-nician
could see the patient’s order, what they had already
ordered that day and all the nutritional information,” says
Lusk. “If the patient requested an item that exceeded the lim-its
of their heart-healthy diet, the technician advised them
in selecting a substitute within the physician-ordered plan.”
While this system has been effective at keeping patients
under their recommended sodium and fat intake while in the
hospital, it does not allow enough time for the patient’s taste
buds to adjust to the drastic change. Often, patients stop fol-lowing
the dietary restrictions after discharge, which can lead
to further medical complications down the road.
“If I were caring for someone in an outpatient setting,
I would work with them and transition them over several
weeks to a healthier meal plan,” Lusk says. “We want to have
that kind of long-term success with our inpatients so that
they aren’t at risk for being readmitted to the hospital because
they did not follow their diet as soon as they went home.”
Educating Through Choice
With the pilot program, patients can order whatever they like
off of the menu, even if it exceeds their dietary restrictions for
fat and/or sodium. If the meal is not within the heart-healthy
guidelines, it will have a yellow heart alert card with it. If the
patient’s total meals for the day exceed the recommended
dietary restrictions, the meal will have a red heart alert card.
The medical team then works with the patient to educate him
or her about making better dietary choices.
“We know that people often make better choices when
they are in control of the choice, as opposed to someone
telling them what to do,” says Travis Watt, associate director
of patient services at UNC Hospitals. By allowing patients to
choose their meals while teaching them about heart-healthy
foods, they will be better equipped to continue making good
choices once they are back home.
“For patients who do not choose the healthier options
while they are in the hospital and who continue to be non-compliant
to their medical team’s recommendations, the
medical team has more information to appropriately pre-scribe
medications upon discharge,” adds Watt.
All patients are also referred to an outpatient nutritionist
to continue the transition to a heart-healthy diet once they
leave the hospital.
Ultimately, this program is about education. “It is unique
because of the give and take of knowledge of what the patients
are actually eating and working with a medical team so that
we’re managing that noncompliance factor,” Lusk says. “We’re
providing intense education and taking it to the next level.”
20 Winter 2014 Well
NutritioN
Bean and Butternut
Squash Tacos
When preparing your next meal,
consider UNC Health Care’s bean and
butternut squash tacos. This heart-healthy
recipe is ideal for a Mexican-inspired
dish at home.
Ingredients
4 c. butternut squash, peeled and diced
into ½-inch cubes
4 small red chilies, dried
2 cloves garlic, unpeeled, smashed and
left whole
1 Tbsp. extra-virgin olive oil
¾ tsp. dried oregano, preferably
Mexican, divided
¼ tsp. cumin seeds
½ tsp. ground toasted cumin seeds,
divided
2 c. cooked pinto or black beans, drained
½ tsp. chili powder
Freshly ground pepper to taste
8 (6-inch) corn tortillas
½ c. fresh cilantro leaves
½ c. red or green cabbage, finely
shredded
8 tsp. queso fresco or feta cheese,
crumbled
Directions
1. Preheat oven to 400 degrees.
2. Put squash in a medium bowl and
use kitchen shears to finely snip chilies
into small pieces into the bowl. Add gar-lic,
olive oil, ½ tsp. oregano and whole
cumin seeds, then toss to coat. Arrange
on a baking sheet in a single layer and
bake until soft and beginning to brown
(20 to 25 minutes). Peel and finely chop
garlic, then stir into squash.
3. Combine beans in a small saucepan
with the remaining ¼ tsp. oregano,
ground cumin, chili powder and pepper.
Heat over medium-low heat for about
10 minutes.
4. Warm tortillas. Spoon ¼ cup of the
warm beans into each tortilla and divide
the roasted squash evenly among the
tacos. Top each with cilantro, cabbage,
salsa and cheese.
Nutritional Information per
Serving
(Makes 4 servings of two tacos each)
406 calories, 13 g protein, 9 g fat,
142 mg sodium.
For a lower-calorie option: Try this
dish as a bowl with the cabbage as the
base. It will bring your calories down to
316 per serving!
Try It! Then Tell Us
Visit our Facebook page and tell us about
your experience making this recipe at home:
www.facebook.com/unchealthcare.
Photo: Rebecca cates
www.unchealthcare.org 21
ResouRces
uNc center for Heart and
Vascular care Locations
uncheartandvascular.org
chapel Hill
UNC Heart & Vascular Center
at Meadowmont
300 Meadowmont Village Circle
(919) 966-7244
uNc Hospitals
101 Manning Drive
(919) 843-1283
Roxboro
UNC Heart & Vascular
of Roxboro
3762 Durham Road
(336) 599-1077
sanford
Sanford Specialty Clinic
1301 Central Drive
(919) 718-9512
siler city
Chatham Primary Care
163 Medical Park Drive,
Suite 210
(919) 742-6032
Yanceyville
Caswell Family
Medical Center
439 U.S. Highway 158 W.
(336) 694-9331
Heart and vascular clinics,
services, programs and screenings
offered by UNC Hospitals, Rex Healthcare
and North Carolina Heart & Vascular
Rex cardiothoracic
surgical specialists
rexcardiosurg.com
Raleigh
Rex Medical Office Building
2800 Blue Ridge Road,
Suite 403
(919) 784-7110
Rex Vascular specialists
rexvascular.com
Holly springs
Rex Healthcare of Holly Springs
781 Avent Ferry Road, Suite 106
(919) 784-2300
Raleigh
Rex Medical Plaza
4414 Lake Boone Trail, Suite 108
(919) 784-2300
Wakefield
Rex Healthcare of Wakefield
11212 Galleria Ave., Suite 101
(919) 784-2300
North carolina Heart
& Vascular Locations
ncheartvascular.com
Benson
3333 N.C. Highway 242 N.
(919) 989-7909
cary
1505 SW Cary Parkway,
Suite 300
(919) 387-3260
clayton
2076 Highway 42 W.
(919) 359-0322
clinton
603 Beaman St., Suite 5
(919) 231-8253
Garner
300 Health Park Drive,
Suite 200
(919) 250-2260
Goldsboro
2615 Hospital Road, Suite 300
(919) 736-8655
Granville
102 Professional Park, Suite C
(919) 690-8853
Knightdale
6905 Knightdale Blvd., Suite 103
(919) 573-1220
Lillington
701 S. Main St.
(910) 814-3201
Louisburg
500 Redwood Lane
(919) 496-3909
Mount olive
201 N. Breazeale Ave.
(919) 736-8655
Raleigh—Blue Ridge Road
2800 Blue Ridge Road,
Suite 550
(919) 787-5380
Raleigh—Lake Boone Trail
4414 Lake Boone Trail, Suite 402
(919) 784-5600
Raleigh—
New Bern Avenue
3000 New Bern Ave.,
Suite G100
(919) 231-8253
Rocky Mount
901 N. Winstead Ave.,
Suite 44
(919) 231-8253
smithfield
910 Berkshire Road
(919) 989-7909
Wakefield
11200 Governor Manly Way,
Suite 303A
(919) 570-7590
Wake Forest
1966 S. Main St.
(919) 570-1252
Wilson
2605 Forest Hills Road SW
(252) 243-7161
uNc Wellness
center Locations
uncwellness.com
Meadowmont
100 Sprunt St.
(919) 966-5500
Northwest cary
350 Stonecroft Lane
(919) 957-5900
Rex Cardiothoracic
Surgical Specialists
Rex Vascular Specialists
of Raleigh
UNC Wellness Center
at Meadowmont
Photos of facilities: Brian strickland
22 Winter 2014 Well
Rex Wellness
Center Locations
rexhealth.com/wellness
Cary
1515 SW Cary Parkway
(919) 387-0080
Garner
1400 Timber Drive E.
(919) 661-6100
Knightdale
6602 Knightdale Blvd.
(919) 747-5360
Raleigh
4200 Lake Boone Trail
(919) 784-1371
Wakefield
11200 Galleria Ave.
(919) 570-1511
OTHER
HEaRT-HEaLTHy
PROGRams & sERviCEs
Cardiac Rehabilitation
Cary*
Rex Wellness Center of Cary
(919) 784-3756
Chapel Hill*
UNC Wellness Center at
Meadowmont
(919) 843-2158
Raleigh*
Rex Wellness Center of Raleigh
(919) 784-3756
Cholesterol Screenings
Cary
Rex Wellness Center of Cary
Chapel Hill*
UNC Lipid Prevention Clinic
UNC Heart and Vascular Center
at Meadowmont
Clayton*
North Carolina Heart &
Vascular—Clayton
Garner
Rex Wellness Center of Garner
Goldsboro*
North Carolina Heart &
Vascular—Goldsboro
Knightdale
Rex Wellness Center
of Knightdale
Lillington*
North Carolina Heart &
Vascular—Lillington
Raleigh
Rex Wellness Center of Raleigh;
North Carolina Heart &
Vascular—Raleigh, Blue Ridge
Road and New Bern Avenue*
smithfield*
North Carolina Heart &
Vascular—Smithfield
Wakefield
Rex Wellness Center
of Wakefield
Wilson*
North Carolina Heart &
Vascular—Wilson
Community Screenings
(appointment required)
Raleigh
Rex Healthcare
(919) 78-HEART
(919-784-3278)
Nutrition & Weight Loss
Cary
Healthy Way
Rex Wellness Center
of Cary
Chapel Hill*
Weigh to Wellness
UNC Wellness Center at
Meadowmont
(919) 843-2186
Clayton*
North Carolina Heart &
Vascular—Clayton
Garner
Healthy Way
Rex Wellness Center of Garner
Goldsboro*
North Carolina Heart &
Vascular—Goldsboro
Knightdale
Healthy Way
Rex Wellness Center
of Knightdale
Lillington*
North Carolina Heart &
Vascular—Lillington
Raleigh
Healthy Way, Rex Wellness
Center of Raleigh; North
Carolina Heart & Vascular—
Raleigh, Blue Ridge Road and
New Bern Avenue*
smithfield*
North Carolina Heart
& Vascular—Smithfield
Wakefield
Healthy Way
Rex Wellness Center of Wakefield
Wilson*
North Carolina Heart &
Vascular—Wilson
Smoking Cessation
Chapel Hill
UNC Nicotine
Dependence Program
UNC Family Medicine Center
590 Manning Drive
(919) 966-0210
Clayton*
North Carolina Heart &
Vascular—Clayton
Goldsboro*
North Carolina Heart &
Vascular—Goldsboro
Lillington*
North Carolina Heart
& Vascular—Lillington
Raleigh
Rex HealthNet; North Carolina
Heart & Vascular—Raleigh,
Blue Ridge Road and New Bern
Avenue*
smithfield*
North Carolina Heart &
Vascular—Smithfield
Wilson*
North Carolina Heart &
Vascular—Wilson
Support Groups
Chapel Hill
UNC Cardiac Survivors’
Support Group
UNC Wellness Center at
Meadowmont
(919) 843-2154
Raleigh
Mended Hearts Program
Rex Hospital
4420 Lake Boone Trail
(919) 784-3756
*Physician referral required
Can’t Find it?
If you need assistance finding
physicians, clinics and ser-vices
not listed here, please
contact UNC HealthLink or
Rex HealthNet.
Chapel Hill
UNC
HealthLink
(919)
966-7890
Raleigh
Rex HealthNet
(919)
784-4490
Rex Wellness Center
at Wakefield
Rex Hospital
in Raleigh
Coming Soon!
Rex Healthcare will
offer heart and vascular
screenings to all of its
service areas through a new
mobile screening coach.
www.unchealthcare.org 23
www.med.unc.edu
UNC School of Medicine is proud to celebrate
our top rankings, which reinforce our position as
a national leader in both education and research.
We salute our physicians who contribute to high
quality delivery of primary care and our researchers
who lead innovations for the future of health care.
UNC SCHOOL OF MEDICINE RANKINGS
Overall
Primary Care, 1st
Research, tied for 22nd
Specialty areas
Family Medicine, 2nd
Rural Medicine, tied for 5th
Audiology, 3rd*
Occupational Therapy, tied for 10th*
AIDS, tied for 9th
Physical Therapy, tied for 9th*
Speech-Language Pathology, tied for 11th*
Women’s Health, 15th
* Specialties last ranked by U.S. News & World
Report in 2012.
Medic al
1School #
foir Pr ym ar Care
by U.S. News & World Report
ranked
“America’s Best Graduate Schools”
University of North Carolina Hospitals at Chapel Hill
101 Manning Drive
Chapel Hill, NC 27514-4220
Nonprofit Org.
US Postage
PAID
UNC
HOSPITALS