Dual-heart medicine, also known as psychocardiology or psychocardiology, is a discipline formed by the intersection and integration of cardiology and psychology. It is based on the discipline system of cardiovascular diseases, emphasizing the impact of mental and psychological states on the body while focusing on improving cardiovascular diseases, in order to achieve the best patient prognosis, treatment effect, and disease outcome.
With the continuous progress of society and the rapid development of medicine, the concept of “dual-heart medicine” is gradually gaining popularity, with more and more doctors paying attention to this discipline. More hospitals are establishing dual-heart clinics to provide more comprehensive medical services to patients. In 2023, the Affiliated Beijing Chaoyang Hospital of Capital Medical University (referred to as “Chaoyang Hospital” below) also joined this trend. Recently, Kangxun.com interviewed one of the founders of the Cardiac-Psychiatric Joint Clinic at Chaoyang Hospital, Professor Wang Zhe, to give us a comprehensive understanding of this important clinical discipline.
Original intent of setting up Dual-heart clinic:
Comprehensively safeguard the physical and mental health of patients
Speaking of the original intent of establishing the dual-heart clinic, Professor Wang Zhe said, “Clinically, cardiovascular disease patients often have mental and psychological problems that mutually influence each other, exacerbating the disease. For example, mental and social risk factors such as depression, social isolation, and emotional abnormalities are closely related to the onset of cardiovascular diseases. In addition, the occurrence and development of cardiovascular diseases may also lead to the emergence of mental and psychological problems, with complex interactions between the two. In non-psychiatric specialties, the underdiagnosis and mistreatment of psychiatric patients are extremely common, with one of the significant reasons being the somatic manifestations of psychiatric diseases. Many patients present with various somatic symptoms, even denying the existence of mental illnesses, which leads to unsatisfactory treatment outcomes. Dual-heart medicine emphasizes not only focusing on cardiovascular diseases but also on the mental and psychological states of patients. The dual approach to treatment often yields unexpected therapeutic results, helping patients overcome the distress of diseases.”
To achieve this goal, under the leadership of Professor Wang Zhe from the Cardiac Center and Professor Shi Hui from the Department of Psychology, Chaoyang Hospital officially launched the Dual-heart Clinic on December 21, 2023. The clinic brings together multiple senior doctors from the Department of Cardiology and Clinical Psychology, who not only possess deep medical knowledge but also have rich clinical experience, dedicated to providing more comprehensive and professional diagnostic and therapeutic services to a large number of patients. Referring to the characteristics of the dual-heart clinic, Professor Wang Zhe summarized them into three key points:
1. Holistic medical model: The dual-heart clinic dispatches one physician from the Department of Cardiology and one from the Department of Psychology to jointly develop a comprehensive treatment plan. It not only focuses on heart issues but also diagnoses and treats from the perspective of the heart-brain axis, meeting the personalized treatment needs of patients.
2. Precision medical model: Utilizing advanced methods such as endothelial function testing, heart rate variability, drug gene screening, blood drug concentration testing, etc., to achieve precise drug therapy, providing more effective medical treatment plans.
3. Individualized treatment model: Employing non-pharmacological intervention methods such as biofeedback, non-invasive neuroregulation techniques, etc., to provide more personalized and humane treatment support to patients.
Up to now, the monthly outpatient volume of the dual-heart clinic has reached 300 visits, and it has established a cooperative relationship with the Cardiovascular Department’s inpatient department to provide a direct consultation and treatment channel for patients with anxiety, depression, and insomnia in the inpatient ward, comprehensively improving the efficiency of diagnosis and treatment and the quality of life of patients, allowing more and more patients to achieve “dual” health in mental, psychological, and physical aspects.
Rejecting the hesitation towards seeking medical advice, the Dual-heart Clinic is not far from us
Discussing the difficulties encountered by the dual-heart clinic at its establishment, Professor Wang Zhe said, “Clinically, many patients with symptoms like chest tightness, chest pain, palpitations, and shortness of breath find it difficult to connect their manifestations with mental and psychological disorders. They struggle to understand why mental and psychological problems could lead to chest tightness and chest pain, hence often ignore them. Another major reason is the significant stigma associated with mental and psychological disorders in society. Additionally, there is a negative public perception regarding anti-anxiety and antidepressant medications, believing that they have significant adverse effects and can lead to dependency and addiction. Due to these reasons, many patients refuse to seek help from the psychological department.”
To raise awareness of the dual-heart clinic, Professor Wang Zhe and Professor Shi Hui regularly release health education content on the hospital’s official WeChat account and Weibo, and conduct popularization campaigns through channels such as “Beijing Daily” to increase public understanding of dual-heart medicine.
Additionally, Professor Wang Zhe advises individuals to visit the Dual-heart Clinic if they experience the following situations:
1. Having cardiovascular diseases along with emotional issues: Having clear cardiovascular issues, feeling heart discomfort and unstable symptoms even after undergoing systematic treatment, and experiencing anxiety, depression, insomnia, etc.
2. Repeatedly experiencing heart discomfort but difficult to diagnose: Experiencing various heart discomforts such as palpitations, chest tightness, chest pain, seeking multiple consultations in the Department of Cardiology, undergoing repeated examinations without a clear diagnosis.
3. Developing emotional issues after cardiac surgery: Experiencing anxiety, depression, memory decline, insomnia, etc., during recovery treatment after heart interventions or cardiac surgery.
4. Taking psychiatric medication while experiencing heart-related issues: Taking psychiatric medications for a long time, experiencing abnormal indicators such as blood lipids, electrocardiograms, or experiencing heart discomfort, unstable blood pressure, etc.
Professor Wang Zhe emphasized, “Clinically, incorporating psychological assessment and interventions can increase the treatment success rate of heart disease patients by at least 30%, and the success rate of symptom improvement by 50%. Therefore, it is essential for each individual to have a correct understanding of clinical psychology as a discipline, overcome the stigma associated with mental and psychological illnesses, as mental and psychological disorders, high blood pressure, and heart disease are all various diseases and there is no distinction between them.”
Inviting interdisciplinary collaboration to embark on a new chapter for the Dual-heart clinic
Discussing the future development of the dual-heart clinic, Professor Wang Zhe expressed a commitment to continuing multidisciplinary cooperation. He said, “From the current situation, mere collaboration between cardiology and psychology is far from sufficient. From the perspective of presenting symptoms, the dual-heart clinic is associated with many departments. For instance, patients with heart and psychological diseases who also have chronic bronchitis, emphysema, etc., require the intervention of the Respiratory Department; patients undergoing tumor chemotherapy may experience myocardial damage or insomnia during chemotherapy, necessitating consultations between the Oncology Department and the dual-heart medicine, etc. Therefore, we look forward to having more disciplines join us in the future to collectively embark on a new chapter for health.”
Regarding more long-term goals, Professor Wang Zhe stated, “We look forward to establishing a development model for training specialists in the Dual-heart mode in the future. Currently, our team includes future resident cardiologists who are gradually deepening their understanding of drug use for mental and psychological disorders and common psychological problems in cardiology through involvement in research and practice of the Dual-heart mode. This practical experience will lay a solid foundation for their future professional development.
Furthermore, we will combine advanced concepts with profound professional knowledge, striving to cultivate genuine cardiology-mental health specialists and provide related professional training. In this process, we hope to establish cooperative relationships with international scholars to co-author professional textbooks and promote the popularization and application of the Dual-heart mode within internal medicine systems. Additionally, we plan to conduct relevant training for psychiatric specialists to further advance the innovation and development of the Dual-heart mode.”
Increasing clinical practices prove that only by implementing “Dual-heart medicine” can we better care for patients’ sufferings and respect their feelings. Physicians, when treating diseases, are addressing the heart, prescribing medications, and providing care. In other words, “Dual-heart medicine” is a medical discipline that makes medicine warm and harmonizes doctor-patient relationships, by treating both hearts simultaneously, achieving a “double-win” in physical and psychological health. Finally, the Dual-heart Clinic at Chaoyang Hospital sincerely welcomes a broad range of patients for treatment. The Dual-heart Clinic is not just a place for medical services but also a continuous effort platform for the health and quality of life of patients.
Expert Bio
Professor Wang Zhe, Affiliated Beijing Chaoyang Hospital, Capital Medical University
Chief physician, professor, Department of Cardiology, Affiliated Beijing Chaoyang Hospital, Capital Medical University
Social or academic positions: Committee member of the Beijing Medical Association Non-invasive Electrocardiac Functional Evaluation Group, young member of the Beijing Physician Association Hypertension Professional Committee, Committee member of the Beijing Medical Association Cardiovascular Pharmacology Group, Committee member of the Beijing Chronic Disease Prevention and Health Education Association Hypertension Branch, Committee member of the Chinese Volunteer Association Chinese and Western Medicine Combination Expert Volunteers Committee
Published more than twenty Core Journal papers, several SCI articles, and has been involved in applying and researching multiple scientific funding projects and participating in numerous international multicenter large clinical trials.
Has been working in the Department of Cardiology at Beijing Chaoyang Hospital since the beginning of his career, serving as a resident physician, attending physician, associate chief physician, and chief physician. Long-term frontline clinical work specialist in the clinical diagnosis and treatment of diseases such as hypertension, coronary heart disease, heart failure, blood lipid metabolism disorders, dual hearts, insomnia, etc. Rich experience in the rescue and treatment of acute and critical situations in cardiology, such as angina, acute myocardial infarction, myocarditis, hypertensive crisis, etc. Proficient in the screening, diagnosis, and treatment of refractory and secondary hypertension. Experienced in the diagnosis and treatment of coronary heart disease and arrhythmias. In-depth research on blood lipid metabolism disorders and arteriosclerosis. In terms of teaching, responsible for theoretical teaching of electrocardiography at Capital Medical University, serving as a standardized training teacher for resident physicians and a specialized physician training mentor.
Review expert | Professor Wang Zhe, Affiliated Beijing Chaoyang Hospital, Capital Medical University
Editor | Lu Lu
Reviewer | Feng Xiwen
Review expert | Professor Wang Zhe, Affiliated Beijing Chaoyang Hospital, Capital Medical University
Editor | Lu Lu
Reviewer | Feng Xiwen
