The Three-Legged Stool of Heart Health: Lifestyle Practices, Getting Care When You Need It (Even in a Pandemic) and the Role of Cardiac Rehabilitation

Carol Wolfenbarger

Carol Wolfenbarger

By Carol Wolfenbarger, MSN, RN, FACHE

There is no better time than February, which happens to be American Heart Month, to highlight the advanced cardiology services that we offer here at Mission Hospital McDowell [1] (MHM). Heart disease remains the No. 1 killer of men and women in the United States, and in addition to heart attack, other common heart problems include heart failure, or weakening of the heart, resulting in fluid accumulation and abnormal heart rhythms.

We are fortunate to have R. Croft Thomas, MD, with us now as our supervising cardiologist, as he has special expertise in cardiac imaging and extensive experience in diagnosing and treating the many heart issues that affect our patients. He assumed this role on December 1 and comes to us from Asheville Cardiology, the historically premier cardiology practice in the Carolinas. He is now focusing on providing community care and treats patients here at MHM Tuesday through Friday of each week, while serving patients in the Spruce Pine community at Blue Ridge Regional Hospital on Mondays.

“I care for patients who have had cardiac events,” says Dr. Thomas, “and offer preventive care to patients who have not experienced any heart disease yet.” He explains that though many patients are referred to a cardiologist after they suffer symptoms of heart disease or experience a cardiac event, there is a bigger role for utilizing the services of cardiologists in the preventive care sphere. “If there are heart attack and stroke risk factors that a patient’s primary care physician feels need to be addressed — if a patient needs help getting their blood pressure or cholesterol under control, for example — they’re referred to me. Once I treat a patient, I often maintain a lifelong relationship with them,” adds Dr. Thomas.

Patients play an important role in their own care when they learn about what a truly heart-healthy lifestyle consists of and institute these practices. Dr. Thomas notes that some of the most important things one can do to support their heart health are to eat a balanced, nutritious diet rich in fruits, vegetables, whole grains and lean protein, get adequate daily exercise, manage stress effectively and maintain a healthy weight. “It’s just as important to stay away from the foods that aren’t healthy as it is to choose healthier foods,” declares Dr. Thomas, “and that means cutting out cookies, cakes and other sweets. Aim for 150 minutes of aerobic exercise per week — enough to work up a light sweat — or about 30 minutes, five times a week.” As for stress management, he mentions that it looks different for everyone, but preferably involves exercise, though may also include anything from knitting to yoga, or gardening to taking a socially distanced walk with a friend. Finally, rest is critical, and Dr. Thomas says that a particular concern he has is for those patients who work third-shift jobs. “I pay special attention to them because the dysregulated sleep and overall disruption that results from this lifestyle can contribute to other habits that are harmful to the heart, such as craving the wrong foods and feeling consistently fatigued, thus causing the patient to avoid exercise,” he says.

Dr. Thomas also stresses the importance of “knowing your numbers,” which gives you an overall awareness of your risk for not only heart disease, but other serious conditions, such as diabetes. “When we use this phrase, we mean patients should be aware of their body mass index (BMI), which indicates whether the ratio of their weight to height is in a healthy or risky range, blood pressure, cholesterol and A1C, which is your blood glucose level,” he shares. “Now we consider 130/80 to be a healthy blood pressure, but the lower it is the better, and it’s a good idea to bring a log to your doctor’s appointment. It’s important also to remember that having diabetes is a strong risk factor for heart attack and stroke, and to aim for an A1C < 7.0% goal. Finally, keep on top of your ‘bad’ cholesterol (LDL), as it should be under 100 or even 70 in some cases.” A concern Dr. Thomas says too, is that he is seeing younger people being diagnosed with heart disease, and knowing these baselines can help patients in their efforts to control their risk factors.

When a person has suffered a heart attack or other problem where intervention was needed, cardiac rehabilitation is a critical recovery component. MHM’s program allows participants to be closely supervised as they perform their customized exercise regimen, offers education on all aspects of living a heart-healthy life and affords them the opportunity to build relationships with their peers who share some of the same experiences. “Studies show that cardiac rehabilitation reduces cardiovascular death after heart attack or stenting,” says Dr. Thomas.

Dr. Thomas stresses the importance of seeking care immediately if you suffer any heart attack symptoms, and not to let the fear of COVID-19 interfere. MHM is one of the safest places for patients, due to the safety protocols we have long observed. “Never delay calling 911 if you experience chest pain or pressure, and be aware that women and the elderly can experience atypical symptoms like back and jaw pain, abdominal pain, or upset stomach and nausea,” he urges.

“Now that I’ve transitioned to caring for patients in this smaller community, I have the privilege of connecting with and treating more than one member or generation in a family, and really becoming established into the fabric of this wonderful community,” says Dr. Thomas. “These people mean a lot to me, and they motivate me to do my absolute best in their service.”

There’s no question that MHM is richer and our patients better off for having Dr. Thomas with us now.

MHM is here to provide diagnostic screening for heart disease, from echocardiography and nuclear stress testing to heart CTs and EKGs, as well as thorough but timely assessment and intervention in our emergency department (ED) if you have cardiac symptoms. Our emergency team, beginning in the field with EMS and continuing on to our ED, then to Mission Hospital if heart catheterization is indicated, is fine-tuned! Remember, heart disease continues to be No. 1 for taking lives — as we continue to navigate COVID-19, focus on healthy behaviors and do not delay care for symptoms of a heart attack.

Mission Hospital McDowell


Carol Wolfenbarger, MSN, RN, FACHE, is Chief Executive Officer of Mission Hospital McDowell.

Mission Hospital McDowell, [1] a member of Mission Health, an operating division of HCA Healthcare, is a community hospital serving McDowell County. Located in Marion, North Carolina, Mission Hospital McDowell operates 30 beds including 5 labor and delivery suites. Medical specialties offered include family medicine, internal medicine, pediatrics, orthopedics, urology, obstetrics and gynecology, and walk-in, non-emergency care at Mission My Care Now McDowell. Five of Mission Hospital McDowell’s primary care practices have been recognized by the Centers for Medicare & Medicaid Services as Rural Health Clinics.