Heart and Vascular Care

417.347.5000

Nationally Recognized Heart Care In Your Town

After a heart attack, blood flow stops – the sooner doctors restore blood flow the better, because time is muscle and every wasted minute causes permanent heart damage. Freeman Heart & Vascular Institute, located in Joplin, Missouri, offers you rapid, expert care. Recognized by Anthem Blue Cross and Blue Shield in Missouri as a Blue Distinction Center® for Cardiac Care, Freeman Heart & Vascular Institute provides all cardiac services in one convenient location. Services include preventive care, emergency interventions, diagnostics, open-heart surgeries, structural heart clinic, rehabilitation, cardiology clinics and education. The facility, a three-story wing adjacent to Freeman Hospital West, has three state-of-the-art operating suites and four cardiovascular catheterization labs. Research is an integral part of our heart and vascular program. We participate in many national studies of cardiovascular treatment. From time to time, patients may be offered the opportunity to participate in clinical trials.

 

Cardiology: 347.5000, Cardiovascular and Thoracic Surgery: 347.5001

Freeman Heart & Vascular Institute

Joplin, MO

Visit us

Level I STEMI Center

Minutes matter in a cardiac emergency. Freeman Health System is now designated as a Level I STEMI Center by the Missouri Department of Health and Senior Services. 

The new designation – the highest of four – means that Freeman has a consistently proven plan and record of dealing with every aspect of ST-segment elevation myocardial infarction (STEMI), a potentially deadly heart attack. The health system is only one of 23 in Missouri classified under the top-level designation. 

The Level I STEMI Center designation is part of the state’s Time Critical Diagnosis System, which identifies hospitals specially equipped to treat STEMI, stroke and trauma patients and improves both the speed and quality of care. The system coordinates the 911 response system, ambulance services and hospitals in a comprehensive, integrated approach. 

With the Level I STEMI Center designation, Freeman is setting the standard for excellence in heart care throughout the four-state area.

 

Cardiothoracic Surgery

Cardiothoracic surgery provides treatment for patients with a wide range of conditions affecting the heart, as well as the respiratory and circulatory systems. We combine innovative technology with expertise and skill to provide the latest in vascular and endovascular surgical options.

Many of the procedures are performed using minimally invasive approaches through small incisions and with video assistance devices. Minimally-invasive beating heart surgery results in less pain and trauma, reduced recovery time, and reduced risk of infection. Patients experience better outcomes, spend less time away from home and return to work sooner.

As a regional center of excellence in heart care, Freeman reinvests in state-of-the-art equipment and the latest technological advancements. Our cardiothoracic surgeons focus on diagnosing and treating your condition quickly to improve your quality of life and get you back to living life as soon as possible.

Cardiothoracic surgical options:

  • Off-pump coronary artery bypass
  • Ross procedure (valve transplantation)
  • Stent placement
  • Vascular diagnostics
  • Minimally invasive microwave ablation (atrial fibrillation)
  • Bypass surgery
  • Endovascular surgery
  • Peripheral vascular surgery
  • Keyhole/minimally invasive valve surgery
  • Mitral valve repair
  • Cardiac valve replacement and repair
  • Cryoablation maze procedure
  • Thoracic surgical procedures (lung surgery)
  • Percutaneous peripheral vascular intervention
  • Video-assisted thoracoscopy
  • Aortic dissection
  • Vascular access grafts

Freeman is on the Leading-Edge of Heart and Vascular Treatment

"One of the most important aspects of the TAVR procedure is the teamwork across medical disciplines. We are together at the operating table taking different roles in guiding, placing and deploying the replacement valve." - Dr. Vetsch on TAVR

Freeman is the First and Only in the Area to Offer These Procedures

    TAVR is a minimally-invasive procedure in which a folded valve is slipped into a catheter, inserted through the groin and threaded up to the heart through the arteries. When the valve reaches its destination near the heart, a balloon inflates to open the valve and secure its position in the artery. Performed in a state-of-the-art hybrid operating room.

    TAVR is done while the heart remains pumping, eliminating the need for a heart-lung machine. The procedure takes an average of 45 minutes to two hours and is done under general anesthesia. Freeman’s median length of in-patient stay post-procedure is 2.06 days.

    TAVR patients begin with a referral to Freeman’s Structural Heart Program, which features a collaborative team of interventional cardiologists, cardiothoracic surgeons and echocardiologists. This team focuses on the diagnosis and treatment of conditions affecting the valves and other vital structures of the heart, providing personalized, coordinated care for the patient.

    Patients go through a comprehensive screening process with the structural heart team prior to the procedure, and then that same team of physicians place the patient’s new heart valve.

    The Structural Heart Program features:

    • Collaborative team of interventional cardiologists, cardiothoracic surgeons and echocardiologists.
    • Diagnosis and treatment of conditions affecting the valves and other vital structures of the heart.
    • Personalized, coordinated care and comprehensive range of medical and surgical treatment options for patients throughout the region.

    To schedule an appointment with a Freeman cardiologist, call 417.347.5000.

    Dr. John Swartz, Freeman Heart & Vascular Institute cardiologist, is the first and only physician in southwest Missouri to use the Medtronic Micra™ Transcatheter Pacing System (TPS). It is the first and only leadless pacemaker in the United States as a treatment option for patients with bradycardia (slow or irregular heart rhythm). The Micra TPS is about the size of a multivitamin, making it 93 percent smaller than traditional devices and the world’s smallest pacemaker.

    Freeman is the first and only hospital in our area to provide the Watchman® implant, a device for patients who are at a high risk for stroke and have atrial fibrillation not caused by a heart valve problem and need an alternative to blood thinners.

    During the 30- to 90-minute procedure, the physician makes a small cut in the patient’s upper leg and inserts a narrow tube through the femoral artery. The physician then guides the Watchman implant, which is the size of a quarter, into the left atrial appendage of the heart. Over time it will heal in and a skin will form over the device. It excludes the left atrial appendage, so no blood clot can form in it.

    The procedure is done under general anesthesia, and the patient is kept overnight for observation. After the procedure, the patient will eventually be placed on an aspirin regimen.

    Types of Heart Conditions

      Coronary artery disease occurs when arteries surrounding the heart become less elastic or clogged as of result of fatty deposits (called plaque or blockage) or blood clots forming along the inside of the artery walls. This condition is also known as hardening of the arteries or atherosclerosis. Plaque causes narrowing of the arteries and forces the heart to work harder to get sufficient blood supply. This puts a strain on the heart, eventually weakening it and resulting in heart failure.

      When a blood clot or plaque completely blocks a coronary artery, the portion of the muscle beyond the blockage does not receive the blood it needs. If any part of the heart is deprived of blood for more than a few minutes, permanent damage can result. This is a heart attack. During a mild heart attack, only a small portion of the heart muscle is damaged. The undamaged part of the heart works harder to compensate. If the heart muscle suffers widespread damage, there may not be enough healthy muscle to keep the heart pumping as it should. Heart failure may result.

       

      Blood pressure is the force of blood pushing against the artery walls when the heart beats. Normally, artery walls are elastic, so they stretch and contract, adjusting to the beating and resting of the heart. As arteries become scarred, hardened or narrowed, they lose elasticity, which puts more pressure on artery walls. Blood moves inefficiently, and the heart must pump harder to push blood through the arteries. When blood pressure remains high for a long time, it can cause thickening or enlargement of the heart’s ventricles. Eventually, the ventricles can no longer pump efficiently, resulting in heart failure.

      The valves between the chambers of your heart keep blood moving forward. When a valve narrows, it restricts the blood flow through the heart, causing an abnormal amount of blood to collect on one side of the valve. This causes the chamber to thicken and pump harder with each beat. Over time, the chamber can weaken. If a valve does not close tightly, blood leaks backward. This strains the heart and causes it to enlarge and hold more blood than it should. In some cases, surgery is required to repair or replace the abnormal valve. Valve disease can lead to heart failure.

      Sometimes when the heart is damaged by diseases such as infection, alcoholism or toxic effects of certain drugs, the chambers enlarge and the heart muscle stretches and weakens, which prevents the heart from pumping effectively.

      Heartwise - Heart Failure Clinic

      You may have felt alarmed to learn you have a chronic cardiac condition. Although receiving this diagnosis may have frightened you, it is treatable. While your heart no longer works as well as it should, many people live with this condition without ever suffering a heart attack. With the right team in place, the right medications and devices prescribed as needed, and the right lifestyle changes, you can enjoy a healthy, happy life. That’s where Heartwise, an initiative focused on empowering patients to better manage their chronic cardiac conditions, can help.

      A chronic cardiac condition usually occurs as the result of a diseased or damaged heart. While many conditions can weaken the heart, common conditions are:

      • Coronary artery disease
      • Heart attack
      • High blood pressure
      • Valve disease
      • Cardiomyopathy

      Symptoms of a chronic cardiac condition can range from mild to severe and vary from person to person. Depending on the cause, symptoms can manifest suddenly or develop gradually. A very mild condition may show no visible signs at all. It is important to recognize the signs as soon as they appear, and treat the condition early with the help of your cardiac healthcare team. Treatment varies from patient to patient. Your cardiac healthcare team will determine the treatment plan that will work best for you.

      For more information, call Freeman Heart & Vascular Institute at 417.347.5000.

      Meet our Heart and Vascular Doctors

      Raymond Vetsch, MD
      Raymond Vetsch, MD

      Cardiothoracic Surgeon

      417.347.5001

      Meet Dr. Vetsch
      C. Ryan Longnecker, MD, FACC, FSCAI
      C. Ryan Longnecker, MD, FACC, FSCAI

      Cardiologist

      417.347.5000

      Meet Dr. Longnecker
      Robert C. Stauffer, MD
      Robert C. Stauffer, MD

      Cardiologist

      417.347.5000

      Meet Dr. Stauffer
      Frank Kim MD, MHA, FACC, FSCAI
      Frank Kim MD, MHA, FACC, FSCAI

      Cardiologist

      417.347.6400

      Meet Dr. Kim
      John M. Cox, DO
      John M. Cox, DO

      Cardiologist

      417.347.5000

      Meet Dr. Cox
      Darwin D. Jeyaraj, MD
      Darwin D. Jeyaraj, MD

      Cardiologist

      417.347.6400

      Meet Dr. Jeyaraj
      W. John Nicholas, MD
      W. John Nicholas, MD

      Cardiologist

      417.347.6400

      Meet Dr. Nicholas
      John F. Swartz, MD
      John F. Swartz, MD

      Cardiologist

      417.347.5000

      Meet Dr. Swartz
      David A. Zuehlke, MD
      David A. Zuehlke, MD

      Cardiologist

      417.347.5000

      Meet Dr. Zuehlke

      Cardiology Clinics

      Freeman Heart & Vascular Institute - Girard
      Freeman Heart & Vascular Institute - Girard

      Girard, KS
      417.347.5000

      Learn more
      Freeman Heart & Vascular Institute - Grove
      Freeman Heart & Vascular Institute - Grove

      Grove, OK
      918.786.8888

      Learn more
      Freeman Heart & Vascular Institute - Miami
      Freeman Heart & Vascular Institute - Miami

      Miami, OK
      918.542.2273

      Learn more
      Freeman Heart & Vascular Institute - Parsons
      Freeman Heart & Vascular Institute - Parsons

      Parsons, KS
      620.421.5203

      Learn more

      PATIENT STORY

      Meet John Tescher - TAVR patient

      Before transcatheter aortic valve replacement, or TAVR for short, I was really weak. Just walking across the room, I’d have to sit down and take a break. Dr. John Cox said my aortic valve was calcified from age. He said when you’re doing something active, like walking, it should transfer fluid from one part of the heart to the other, but mine wasn’t doing that. That’s why I was tired a lot.

      I have a couple other problems – diabetes, Addison’s disease and heart disease – and I’ve had two heart attacks and other heart procedures in the past, so I wasn’t a candidate for open-heart surgery. Dr. Cox recommended TAVR.

      I was one of the first people to have TAVR done at Freeman. I was excited about it. I was a little nervous about stepping into the unknown of a new procedure, but I knew that if it worked, it would be beneficial to my daily life.

      They did the procedure on a Thursday, and I was discharged the next day. I noticed the improvement right away. I felt great again. The only pain was in the groin where they’d inserted the catheter.

      Now, my life is back to normal again. I’ve regained my energy and my strength. I can do whatever I want to do – I can work on my yard or go shopping with my wife. I feel good.

      John Tescher TAVR

      Helpful Resources

        The Freeman Heart Health Assessment, offered free of charge, can help you learn your long- and short-term risk of developing heart disease. The assessment takes approximately 10-15 minutes to complete, and asks demographic questions and medical history questions.

        After completing online assessment, you'll receive a free personalized report that outlines important information about your heart health, including heart age, 10- and 30-year cardiovascular disease risk, and cardiovascular disease risk factors. This report can be printed and downloaded. We encourage you to print your report and bring it to your next appointment with your physician. Take the heart health assessment today!

        Start Now

        Celebrate National Wear Red Day® with Go Red For Women and Freeman Health System to help fight women's #1 killer – heart disease.

        Heart disease claims more lives than all forms of cancer combined. For more than 10 years, the American Heart Association has sponsored National Wear Red Day® to raise awareness in the fight against heart disease in women.

        2014 was the 11th year anniversary for National Wear Red Day® and during that time, there have been some major accomplishments, including:

        • 21 percent fewer women dying from heart disease
        • 23 percent more women aware that it’s their #1 health threat
        • The publishing of gender-specific results, established differences in symptoms and responses to medications, and women-specific guidelines for prevention and treatment
        • Legislation to help end gender disparities

        What causes heart disease?

        Heart disease affects the blood vessels and cardiovascular system. Numerous problems can result from this, many of which are related to a process called atherosclerosis, a condition that develops when plaque builds up in the walls of the arteries. This buildup narrows the arteries, making it harder for blood to flow through. If a blood clot forms, it can stop the blood flow. This can cause a heart attack or stroke.

        But it doesn’t end there. Heart disease can take many other forms as well:

        • Heart failure or congestive heart failure, which means that the heart is still working, but it isn’t pumping blood as well as it should, or getting enough oxygen.
        • Arrhythmia or an abnormal rhythm of the heart, which means the heart is either beating too fast, too slow or irregularly. This can affect how well the heart is functioning and whether or not the heart is able to pump enough blood to meet the body’s needs.
        • Heart valve problems can lead to the heart not opening enough to allow proper blood flow. Sometimes the heart valves don’t close and blood leaks through, or the valve leaflets bulge or prolapse into the upper chamber, causing blood to flow backward through them.

        How can I prevent it?

        Many factors can put you at risk for these problems – some you can control and others you can’t. But the key takeaway is that with the right information, education, and care, heart disease in women can be treated, prevented, and even ended.

        Studies show that healthy choices have resulted in 330 fewer women dying from heart disease per day. Here are a few lifestyle changes you should make:

        • Don’t smoke
        • Manage your blood sugar
        • Don’t smoke
        • Get your blood pressure under control
        • Lower your cholesterol
        • Know your family history
        • Stay active
        • Lose weight
        • Eat healthfully

        Eating foods low in cholesterol and saturated fats can significantly reduce your risk for heart disease. Though your favorite foods often include ingredients to avoid, you can eat right and still enjoy your meals if you follow a few simple guidelines:

        • Limit your cholesterol intake to 300 milligrams per day and total fat to less than 30% of a day’s calories, including no more than 10% of calories from saturated fats. Check food labels for fat content.
        • Cholesterol is found in animal products such as meat, eggs and cheese. Saturated fats, those that remain solid at room temperature, are most commonly found in fatty cuts of meat, whole milk products, butter, and palm and coconut oils.
        • Eat plenty fruits, vegetables, whole grains and legumes such as dried peas and beans. These foods are rich in vitamins and can also help keep your cholesterol levels down.
        • Know that it’s okay to use butter and dressing as long as you use them in smaller portions. Also, give low-fat or nonfat products a try.

        Additionally, it’s important to know the symptoms of a heart attack so you can act right away. The signs of a heart attack aren't the same for everyone. For some, symptoms are sudden and intense. For others, the symptoms are mild and begin slowly. Know the warning signs and act quickly – by calling 911 or going to the nearest emergency room – if you think you're having a heart attack.

        A heart attack does not always have obvious symptoms, such as pain in your chest, shortness of breath and cold sweats. In fact, a heart attack can actually happen without a person knowing it. It is called a silent heart attack, or medically referred to as silent ischemia (lack of oxygen) to the heart muscle.

        It’s important to know your risk factors, be aware of your blood pressure and cholesterol, exercise regularly and avoid smoking to decrease your risk of a heart attack. Above all, listen to your body, and if something isn’t right, talk to a doctor.

        To schedule an appointment (with a referral), call 417.347.5000 or request an appointment online.

        The signs of a heart attack aren't the same for everyone. For some, symptoms are sudden and intense. For others, the symptoms are mild and begin slowly. Know the warning signs and act quickly—by calling 911 or going to the nearest emergency room—if you think you're having a heart attack.

        Symptoms of a heart attack:

        • Discomfort/pain in center of chest that lasts more than a few minutes or goes away and comes back
        • Discomfort in the arm(s), back, neck, jaw, or stomach
        • Shortness of breath
        • Breaking out in a cold sweat, nausea, or light-headedness

        Some heart attack symptoms are more common in women than in men:

        • Stomach, abdominal pain, or unusual chest pain
        • Nausea or dizziness
        • Shortness of breath and difficulty breathing
        • Unexplained anxiety, weakness, or fatigue
        • Palpitations, cold sweat, or paleness

        The cardiologists at Freeman Heart & Vascular Institute use a variety of noninvasive tests to diagnose heart disease and conditions such as angina (chest pain). These tests include state-of-the-art echocardiography, contrast echo, and regular treadmill, stress echo, dobutamine stress echo, and nuclear medicine stress tests. Additionally, Freeman offers computed tomography (CT) and positron emission tomography/computed tomography (PET) imaging.

        Registered vascular technology specialists staff our noninvasive, diagnostic lab for vascular testing using state-of-the-art ultrasound equipment. Tests include cerebral vascular testing, peripheral arterial testing, peripheral venous testing and abdominal Doppler exams.

        Cardiopulmonary rehabilitation improves a patient’s ability to perform the normal activities of daily living. By teaching techniques for dealing with chest pain and shortness of breath, eating habits, cholesterol levels and weight loss, the Freeman rehabilitation program provides a comfortable and familiar environment for recovery, with services available in Joplin and Neosho.

        Did you know the first “symptom” of cardiovascular disease can be a heart attack? Early detection of heart problems gives individuals a chance to seek treatment and make lifestyle changes, decreasing the likelihood of a cardiac event.

        Early detection tests can be as simple as monitoring your blood pressure and your cholesterol. Both high blood pressure and high cholesterol can be controlled with lifestyle changes and/or medication.

        Getting your cardiac calcium score is an even more accurate way to determine cardiovascular risk. This test uses a non-invasive heart to can measure the calcium deposits in the walls of your coronary arteries – the arteries that supply blood to your heart – all without needles, cutting or medication.

        If the test shows that you are at an elevated risk for a heart attack, you can work with your doctor to begin to lower your risk by preventing future buildup of calcium and plaque in your arteries.

        Although anyone can get this screening, it is recommended for men over 40 and women over 45 who have one of the following risk factors:

        • Diabetic
        • Current smoker
        • Obese
        • Family history of heart disease
        • Cholesterol level greater than 160/LDL
        • Blood pressure greater than 140/90

        $99

        Not covered by insurance

        Talk to your doctor for more information.

        Preventing Heart Disease

        Many factors can put you at risk for these problems – some you can control and others you can’t. But the key takeaway is that with the right information, education, and care, heart disease in women can be treated, prevented, and even ended.

        Studies show that healthy choices have resulted in 330 fewer women dying from heart disease per day. Here are a few lifestyle changes you should make:

        • Don’t smoke
        • Manage your blood sugar
        • Don’t smoke
        • Get your blood pressure under control
        • Lower your cholesterol
        • Know your family history
        • Stay active
        • Lose weight
        • Eat healthfully

        Eating foods low in cholesterol and saturated fats can significantly reduce your risk for heart disease. Though your favorite foods often include ingredients to avoid, you can eat right and still enjoy your meals if you follow a few simple guidelines:

        • Limit your cholesterol intake to 300 milligrams per day and total fat to less than 30% of a day’s calories, including no more than 10% of calories from saturated fats. Check food labels for fat content.
        • Cholesterol is found in animal products such as meat, eggs and cheese. Saturated fats, those that remain solid at room temperature, are most commonly found in fatty cuts of meat, whole milk products, butter, and palm and coconut oils.
        • Eat plenty fruits, vegetables, whole grains and legumes such as dried peas and beans. These foods are rich in vitamins and can also help keep your cholesterol levels down.
        • Know that it’s okay to use butter and dressing as long as you use them in smaller portions. Also, give low-fat or nonfat products a try.

        It’s important to know your risk factors, be aware of your blood pressure and cholesterol, exercise regularly and avoid smoking to decrease your risk of a heart attack. Above all, listen to your body, and if something isn’t right, talk to a doctor.

        For more information, call Freeman Heart & Vascular Institute at 417.347.5000.

        Many factors can put your heart at risk. While you cannot control them all, actions like exercising regularly and abstaining from tobacco use can lower your risk.

        Uncontrollable factors

        • Age – Individuals over 65 are at increased risk.
        • Sex – Men are at greater risk than women.
        • Ethnicity – African-Americans, Mexican-Americans, American Indians, native Hawaiians and some Asian-Americans have a higher risk of heart disease than Caucasians.
        • Family history – Individuals with a family history of cardiovascular disease have a higher risk than those who do not.

        Controllable factors

        • Tobacco use
        • High blood pressure
        • High cholesterol
        • Obesity
        • Physical inactivity
        • Diabetes

        Take the Freeman Heart Health Assessment to learn more about your risk and receive a free, personalized report today.

        Start Now

        Cardiac/Medical 1

        In 2007, Freeman opened Gary & Donna Hall Tower at Freeman West. In consideration of future expansion, our senior leaders and Board of Directors left 2 extra floors unfinished: the 5th and 6th floors. After the May 22, 2011, tornado, Freeman experienced a 20% increase in the number of patients staying in the hospital. To meet this demand, we finished these floors, adding 58 private patient rooms, 29 of those in the Cardiac/Medical Unit

        Our goal for this expansion was to reduce wait times and make each patient's hospital experience as pleasant as possible. All of the spacious rooms on the 5th and 6th floors are private, with patient-centered amenities, such as a family area in each room and a place for visitors to sleep.

        The 5th floor opened in March 2012. On the 5th floor, the Cardiac/Medical Unit serves our stroke, low-risk cardiac and medical patients. Each patient bed is equipped with continuous oxygen saturation and advanced wireless cardiac monitoring technology. Nurses on this floor have advanced cardiac training as well.

        Cardiac/Medical 1 room

        Cardiac/Medical 2

        The Cardiac/Medical 2 Unit (CMU-2) opened in the fall of 2013. On the 6th floor, CMU-2 serves as our renal caring unit for patients suffering from kidney disease. Each patient bed is equipped with advanced wireless cardiac monitoring technology, and nurses on this floor have advanced cardiac and dialysis training. The unit has dialysis access for ease in the management of patient care and for patient convenience.

        Patients in both of these new units communicate with nursing staff through a new call light system, chosen by nurses involved in the Shared Governance program. This new system improves efficiency, collaboration and quality of patient care.

        Cardiac/Medical 2 room

        Take-a-Break Snack Mix

        Ingredients

        • Cooking spray
        • 1/4 cup sliced almonds
        • 1 tablespoon light brown sugar
        • 2 teaspoons water
        • 1/4 teaspoon ground cinnamon
        • 1/8 teaspoon ground nutmeg
        • 2 cups whole-grain oat cereal with yogurt-flavored coating
        • 2 cups whole-grain wheat and bran flakes with raisins
        • 1/2 cup dried unsweetened cranberries
        • 1/2 cup dried unsweetened blueberries

         

        Cooking instructions

        Put a piece of aluminum foil about 12 inches square on a platter or baking sheet. Lightly spray with cooking spray. Set aside. In a small nonstick skillet, dry-roast the almonds over medium heat for 2 to 3 minutes, or until lightly golden brown, stirring occasionally.Stir in the brown sugar, water, cinnamon, and nutmeg. Cook for 1 to 2 minutes, or until the liquid has evaporated and the almonds are coated with the mixture, stirring constantly. Transfer to the foil. Let cool completely, 15 to 20 minutes. Meanwhile, in a medium bowl, stir together the remaining ingredients. Add the cooled almonds to the cereal mixture, stirring to combine. Store in an airtight container for up to 7 days.

        Cook's tip

        Whether your schedule is go-go-go or hurry-up-and-wait, you’ll be glad you packed these tasty tidbits for healthy snacking. For variety, substitute different nutrient-dense dried fruits, such as cherries, apricots, and plums, for the cranberries and blueberries. Cut them into 1/4- to 1/2-inch pieces before adding them to the cereal mixture.

        Nutritional Analysis Per Serving

         139 calories, 2.0 g total fat, 0.5 g saturated fat, 0 g trans fat, 5. g polyunsaturated fat, 1 g monounsaturated fat, 0 mg cholesterol, 124 mg sodium, 28 g carbohydrates, 4 g fiber, 15 g sugar, 2 g protein

        Take-a-Break Snack Mix

        Shredded Root Vegetable Pancakes

        Ingredients

        • 1 large egg, lightly beaten
        • 1/4 cup whole-wheat flour
        • 3 tablespoons chopped scallions
        • 1 tablespoon chopped fresh dill or 1 teaspoon dried
        • 1 tablespoon prepared horseradish
        • 1/4 teaspoon salt
        • 1/4 teaspoon freshly ground pepper
        • 4 cups assorted root vegetables, peeled (about 1 1/2 pounds; see Cook Tip) and shredded
        • 2 slices cooked bacon, crumbled (optional)
        • 6 teaspoons canola oil, divided
        • Reduced-fat sour cream for garnish

         

        Cooking Instructions

        Preheat oven to 400°F. Coat a baking sheet with cooking spray. Whisk egg, flour, scallions, dill, horseradish, salt and pepper in a large bowl. Stir in vegetables and bacon (if using). Heat 2 teaspoons oil in a large nonstick skillet over medium heat. Cook 4 pancakes per batch: place about 1/4 cup vegetable mixture in a little of the oil and press with the back of a spatula to flatten into a 2- to 3-inch pancake. Cook until crispy and golden, 1 1/2 to 3 minutes per side. Transfer the pancakes to the prepared baking sheet. Continue with 2 more batches, using the remaining 4 teaspoons oil and vegetable mixture. Transfer the baking sheet to the oven and bake for 15 minutes. Serve garnished with sour cream, if desired.

        Cook's Tip

        Beets, carrots and parsnips are easily peeled with a vegetable peeler, but for tougher-skinned roots like celeriac, rutabaga and turnips, removing the peel with a knife can be easier. Cut off one end of the root to create a flat surface to keep it steady on the cutting board. Follow the contour of the vegetable with your knife. If you use a vegetable peeler on the tougher roots, peel around each vegetable at least three times to ensure all the fibrous skin has been removed. Serves 6.

        Serving size

        2 pancakes

        Nutritional Analysis Per Serving

        106 calories, 6 g total fat, 1 g saturated fat, 3 g monounsaturated fat, 35 mg cholesterol, 180 mg sodium, 12 g carbohydrates, 3 g fiber, 3 g protein, and 294 mg potassium

         

        Vegetable Pancakes

        Oven-Fried Chicken

        Ingredients

        • 1/2 cup nonfat buttermilk (see Cook Tips)
        • 1 tablespoon Dijon mustard
        • 2 cloves garlic, minced
        • 1 teaspoon hot sauce
        • 2 1/2-3 pounds whole chicken legs, skin removed, trimmed and cut into thighs and drumsticks
        • 1/2 cup whole-wheat flour
        • 2 tablespoons sesame seeds
        • 1 1/2 teaspoons paprika
        • 1 teaspoon dried thyme
        • 1 teaspoon baking powder
        • 1/8 teaspoon salt
        • Freshly ground pepper to taste
        • Olive oil cooking spray

         

        Cooking Instructions

        Whisk buttermilk, mustard, garlic and hot sauce in a shallow glass dish until well blended. Add chicken and turn to coat. Cover and marinate in the refrigerator for at least 30 minutes or for up to 8 hours. Preheat oven to 425°F. Line a baking sheet with foil. Set a wire rack on the baking sheet and coat it with cooking spray. Whisk flour, sesame seeds, paprika, thyme, baking powder, salt and pepper in a small bowl. Place the flour mixture in a paper bag or large sealable plastic bag. Shaking off excess marinade, place one or two pieces of chicken at a time in the bag and shake to coat. Shake off excess flour and place the chicken on the prepared rack. (Discard any leftover flour mixture and marinade.) Spray the chicken pieces with cooking spray. Bake the chicken until golden brown and no longer pink in the center, 40 to 50 minutes. Serves 4.

        Cook's tip

        No buttermilk? You can use buttermilk powder prepared according to package directions. Or make “sour milk”: mix 1 tablespoon lemon juice or vinegar to 1 cup milk. To make ahead:, marinate the chicken for up to 8 hours.

        Nutritional Analysis Per Serving

         224 calories, 7 g total fat, 2 g saturated fat, 2 g monounsaturated fat, 130 mg cholesterol, 237 mg sodium, 5 g carbohydrates, 1 g fiber, 34 g protein, 400 mg potassium

        Garlic-Chile Flank Steak

        Ingredients

        • 2 cloves garlic, minced
        • 1/4 cup white vinegar
        • 2 tablespoons canola oil
        • 2 teaspoons ground ancho chile pepper (see Cook Tips)
        • 1 teaspoon dried oregano
        • 1 teaspoon ground cumin
        • 1/4 teaspoon salt
        • 1-1 1/4 pounds flank steak, trimmed of fat

         

        Cooking instructions

        Whisk garlic, vinegar, oil, ground chile, oregano, cumin and salt in a small bowl. Place steak in a shallow baking dish and pour marinade over it, turning to coat both sides. Cover and refrigerate for at least 1 hour, turning once, or overnight. Preheat grill to high heat. Oil the grill rack (see Cook Tips). Grill the steak until desired doneness, 5 to 6 minutes per side for medium. Transfer to a plate, cover with foil and let rest for 5 minutes. Slice the steak very thinly across the grain. Serve warm or chilled. Serves 8.

        Cook's tip

        To oil a grill: oil a folded paper towel, hold it with tongs and rub it over the rack. Do not use cooking spray on a hot grill. When grilling delicate foods like tofu and fish, it is helpful to spray the food with cooking spray.

        Serving size 

        1.5 ounces 

        Nutritional Analysis Per Serving

        98 calories, 5 g total fat, 2 g saturated fat, 2 g monounsaturated fat, 23 mg cholesterol, 55 mg sodium, 12 g protein, 146 mg potassium.

        Garlic-Chile Flank Steak

        Devil's Food Cupcakes with Almond-Mocha Topping on Raspberry Sauce

        Ingredients

        • Cooking spray
        • Cupcakes
        • 1 18.25-ounce box devil’s food cake mix
        • 1 2.5-ounce jar baby food pureed prunes
        • 1 cup strong coffee, or 1 cup water plus 2 teaspoons instant coffee granules
        • 3 large egg whites
        • 2 tablespoons canola or corn oil
        • Sauce
        • 2 12-ounce packages frozen unsweetened raspberries, thawed
        • 1/2 cup sugar
        • 1 1/2 tablespoons cornstarch
        • 1 teaspoon vanilla extract

        Topping

        • 2 teaspoons instant coffee granules
        • 2 teaspoons water
        • 8 ounces frozen fat-free whipped topping, thawed in refrigerator
        • 2/3 cup sliced almonds, dry-roasted

         

        Cooking instructions

        Preheat the oven to 325°F, or as directed on the package. Lightly spray two 12-cup muffin pans with cooking spray. In a large mixing bowl, combine the cupcake ingredients. Follow the package directions for beating the batter and baking and cooling the cupcakes. Meanwhile, in a medium saucepan, stir together the raspberries, sugar, and cornstarch until the cornstarch is dissolved. Bring to a boil over medium-high heat. Boil for 1 to 1 1/2 minutes, or until thickened, stirring frequently. Remove from the heat. Let cool completely, about 20 minutes. Stir in the vanilla. In a medium bowl, stir together the coffee granules and water until the coffee is dissolved. Fold in the whipped topping until well blended. Cover and refrigerate until needed. For each serving, spread 1 tablespoon plus 2 teaspoons raspberry sauce on a dessert plate, top with a cupcake, spoon 1 tablespoon plus 2 teaspoons whipped topping mixture over the cupcake, and sprinkle with about 1 1/2 teaspoons almonds. Serves: 24

        Cook's Tip

        When shopping for cake mix, read the Nutrition Facts labels and choose a product with 0 grams of trans fat. You can refrigerate any leftovers from this recipe for up to 48 hours or freeze them for later use. Keep the cupcakes, the sauce, and the whipped topping in separate airtight containers.

        Serving Size

        1 cupcake

        Nutritional Analysis Per Serving

        173 calories, 4 g total fat, 1 g saturated fat, 0 g trans fat, 1 g polyunsaturated fat, 2 g monounsaturated fat, 0 mg cholesterol, 198 mg sodium, 31 g carbohydrates, 2 g fiber, 18 g sugar, 2 g protein

        Devil's Food Cupcakes with Almond-Mocha Topping on Raspberry Sauce

        Heart and Vascular Awards and Recognitions

        2020 Mission: Lifeline® NSTEMI Gold Recognition Award

        2020 Mission: Lifeline® NSTEMI Gold Recognition Award

        Once again Freeman Heart & Vascular Institute has been recognized by the American Heart Association for outstanding care provided to patients with NSTEMI.  This year, by meeting very high performance thresholds, it received the 2020 Mission: Lifeline® NSTEMI Gold Recognition Award, AHA’s highest achievement for this program. 

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