Pump it up: health care providers add technology, treatment centers and outreach to slow heart disease, the second-leading cause of death in North Carolina.

• Author: Blake, Kathy
• Position: SPONSORED SECTION: CARDIAC CARE

There's a killer on the loose in Nash County. Rocky Mount-based Nash Health Care Systems reported in August that heart disease is the No. 1 cause of death of county residents. "People are sicker here because they don't go see their doctor," says Sarah Heenan, executive director of the system's hometown Nash Heart Center. "They can't go see their doctor, and they can't pay their copay. This is not a community that's easy to care for, but this is our community."

The Nash Heart Center opened in 2011 with 12 chest-pain observation units, a 12-bed pre- and post-catheterization unit, stress-testing rooms and emergency services to streamline care for residents who arrive at the emergency department's doors in some stage of heart attack. Heenan says it is a lifesaver. "We used to have to ship eight to 10 people a month [to other hospitals], so that's the frequency of heart attacks in our community. Now, we have cardiologists who are here 24/7. Because of that, we have people who are alive today. If you come to the [emergency room] and you're having chest pains, we barely even register you and worry about the insurance later."

Nash County's situation isn't unique. The American Heart Association Inc. says heart disease was responsible for nearly 21% of deaths in North Carolina in 2015, slightly behind cancer, the leading cause of death. Health care providers statewide are standing strong in the face of these frightening statistics. They are working to reduce them by adding hospitals, offering outreach programs and developing increasingly intricate surgical techniques and technology.

The cardiology team at Winston-Salem-based Wake Forest Baptist Heart and Vascular Center uses the latest tools to overcome heart abnormalities. The Watchman, for example, prevents strokes in patients with irregular heartbeats--atrial fibrillation--by rerouting blood through the heart. "Look at [the heart] like a room in a house, with a little pantry," says David Zhao, the center's executive director. "You have the front door and the back door, but you're not using the pantry. The blood comes in the front door, but instead of going out the back, it stays in the pantry a long time and forms a clot. The Watchman closes that side door and makes sure nothing goes in the pantry."

Technology also improves reliability. The Micra Transcatheter Pacing System, which is half the size of an AAA battery, is the world's smallest pacemaker. The self-contained device, which received FDA approval in April 2016, is implanted in the patient's heart via a catheter. "The old [style] pacemaker sits under the collarbone, and an electrical wire directs it to the...