Chest Tightness, Palpitations, Shortness of Breath: How This Cardiology Team Safeguards Heart Health

If the human body is compared to a car, the heart is the engine. When the heart malfunctions, symptoms such as chest tightness, chest pain, palpitations, dizziness, and fatigue may occur; in severe cases, sudden cardiac arrest can happen, endangering life.

How can we protect cardiovascular health? Led by Professor Fu Guosheng, its academic leader and department director, the Department of Cardiology at Sir Run Run Shaw Hospital, affiliated with Zhejiang University School of Medicine (hereinafter "the Sir Run Run Shaw Hospital Cardiology Department"), is committed to rescuing patients with high-risk, difficult, and complex cardiovascular diseases. Guided by internationally advanced diagnostic and treatment concepts, the department works tirelessly to reach new heights in medicine.

From only 7 doctors at its founding to a professional team of nearly 100 today, the department has grown into a key discipline with a complete academic system and strong technical capabilities. It has built a comprehensive diagnosis-and-treatment system spanning four subspecialties: coronary intervention, cardiac electrophysiology, cardiac pacing, and structural heart disease. Equipped with an internationally advanced cardiovascular interventional catheterization laboratory and a first-class research platform, the department is dedicated to delivering high-quality medical care.

In 2024, the department's outpatient volume reached nearly 260,000 visits, and inpatient admissions exceeded 25,300. For years it has ranked among the top in Zhejiang Province in core medical indicators such as annual surgical volume, number of discharged patients, and average length of stay.

"Currently, our team is capable of performing almost all of the world's most advanced cardiovascular interventional diagnostic and treatment techniques, striving to provide comprehensive treatment guarantees for patients with all kinds of high-risk, difficult, and complex cardiovascular diseases," said Fu Guosheng.

A Focus on Precise Coronary Intervention

Its level of diagnosis and treatment for high-risk and difficult cases is on par with international standards. The Sir Run Run Shaw Hospital Cardiology Department was one of the first in China, and the earliest in Zhejiang Province, to perform transradial coronary intervention.

Coronary intervention has always been the department's "golden business card." In 2024, it admitted more than 15,000 inpatients with coronary heart disease, accounting for 60% of annual admissions, and successfully performed over 9,300 coronary interventions.

"Our patients have a distinctive feature: a high proportion of high-risk, difficult, and complex vascular lesions, many of them 'tough cases' transferred from grassroots hospitals," Fu Guosheng noted.

Just last week, Mr. Lin, a man in his 50s, was admitted to a local hospital with a sudden acute myocardial infarction. Examination revealed severe stenosis of his left anterior descending artery and complete occlusion of his right coronary artery. During surgery, doctors found his heart vessels severely calcified and tortuous, making it impossible for the instruments to reach the lesion smoothly to restore blood flow. In the emergency, the local doctors contacted Fu Guosheng, and Mr. Lin was transferred to the Sir Run Run Shaw Hospital Cardiology Department by emergency ambulance.

Mr. Lin's condition was classified as chronic total occlusion (CTO) of the coronary arteries, which is extremely difficult to treat. After careful analysis, Fu Guosheng's team drew up a personalized plan: staged management of the two-vessel lesion. First, the left anterior descending artery was reopened and the narrowed segment was successfully dilated with a drug-eluting balloon. One month later, the occluded right coronary artery was opened, achieving complete revascularization.

As coronary heart disease becomes more common, complex and critical cases like Mr. Lin's are on the rise. "Especially for CTO patients, the vascular calcification is often as hard as stone, making revascularization extremely challenging," Fu Guosheng explained. For such cases, the team has built a complete treatment system integrating advanced technologies such as coronary rotational atherectomy and shock wave therapy, reaching internationally advanced levels in technical capability, treatment strategy, and clinical philosophy.

"Vascular lesions vary in complexity," Fu Guosheng stressed. "Our catheterization lab is equipped with a full range of rotational atherectomy burrs, allowing us to select instruments precisely according to vessel size and degree of calcification. For patients with circumferential calcification that cannot be dilated, we innovatively combine rotational atherectomy with shock wave therapy. Successfully treating such complex lesions requires not only the right equipment, technology, and the doctor's experience, but also complete system support."

Beyond CTO, acute myocardial infarction caused by occlusion of the left main coronary artery poses an even greater test for medical teams. Clinically, managing such lesions demands more sophisticated strategic thinking. Fu Guosheng pointed out that every step, from surgical decision-making and stent selection to risk assessment and long-term prognosis management, requires precise functional measurement, imaging evaluation, and abundant clinical experience.

To this end, the department is equipped not only with advanced tools such as intravascular ultrasound but also with an elite cardiac intensive care team. Through the combined use of technologies such as extracorporeal membrane oxygenation (ECMO), the intra-aortic balloon pump (IABP), left ventricular assist devices, and artificial hearts, the team helps high-risk patients through the acute phase, buying time and opportunity for subsequent treatment.

"For these high-risk patients, a moment's 'relaxation' by the doctor may mean the end of a life, but a full-hearted effort brings hope. Even if cardiac function is impaired, a patient can be supported by a cardiac assist device while awaiting a heart transplant opportunity," Fu Guosheng admitted.

While opening the "channel of life," how to help patients go further and live better is another long-term research direction of the department. Led by Zhang Wenbin's team, the department has built a multicenter coronary heart disease cohort in Zhejiang Province. Drawing on real-world big data, it systematically explores and continually optimizes chronic-disease management pathways, develops various intelligent software platforms, and improves the management of perioperative complications of interventional therapy.

The related achievements have been rolled out in more than 30 hospitals nationwide, serving over 10,000 patients. Among them, a mobile-based cognitive behavioral intervention strategy has significantly raised the blood-lipid control rate of coronary heart disease patients by 10 to 25%. The team also leads a major special project under the Ministry of Science and Technology's "Science and Technology Innovation 2030," focusing on lipid management in ultra-high-risk cardiovascular populations and advancing the standardization and precision of chronic coronary heart disease care.

Not Only Saving Severe Heart Attack Patients, but Helping Them Live Well

In China, the mortality rate of acute myocardial infarction remains high, for two reasons. On one hand, delayed treatment: some patients develop critical infarction because they seek care too late, increasing the difficulty of treatment. On the other hand, insufficient intensive-care capacity: there is currently a lack of a team-based, standardized advanced life-support system for patients with severe complications such as cardiogenic shock, pump failure (a state in which the heart's contraction or relaxation is severely impaired and it cannot pump enough blood to meet the body's needs), malignant arrhythmia, and cardiac rupture.

On this basis, the Sir Run Run Shaw Hospital Cardiology Department, together with key members of the cardiac surgery, critical care medicine, and catheterization lab teams, is working to solve the treatment of severe heart attack patients.

Earlier this year, Zhejiang Province announced its first batch of "small but strong" clinical innovation teams, and the severe myocardial infarction team of the Sir Run Run Shaw Hospital Cardiology Department was among those selected.

"For severe heart attack patients, beyond reopening the culprit vessels as soon as possible per the acute infarction protocol, it is even more important to carry out a systematic, comprehensive, and precise assessment, make rapid and reasonable treatment decisions, choose the right mechanical circulatory support, and provide comprehensive and effective adjuvant drug therapy. Our goal is not just to save patients' lives, but to help them live well and return to normal life as much as possible," said Huang He, vice president of Sir Run Run Shaw Hospital and clinical director of the severe myocardial infarction team.

Mr. Liu, a man in his 40s from Taizhou, suffered a sudden acute myocardial infarction: 90% stenosis of the left circumflex artery, 90% stenosis of the right coronary artery, and complete occlusion of the left anterior descending artery, an extremely critical condition. Although the local hospital reopened some vessels, Mr. Liu still developed severe heart failure, unable to lie down and with unstable blood pressure. Upon receiving the consultation request, the severe myocardial infarction team of Sir Run Run Shaw Hospital rushed to the local hospital, placed Mr. Liu on ECMO on-site, and escorted him to Hangzhou for transfer. The team then carried out a series of treatments, including optimizing hemodynamic management, opening the remaining occluded vessels, and achieving complete revascularization.

Two weeks later, the ECMO was successfully removed. According to Mr. Liu's condition, the team dynamically adjusted the treatment plan and combined it with systematic rehabilitation training. After nearly two months of intensive care, Mr. Liu recovered and was discharged smoothly.

"As one of China's first chest pain centers and coronary intervention training centers, we admit more than 22,000 inpatients with cardiovascular disease every year, accumulating rich clinical experience and the corresponding key core techniques in treating critical acute myocardial infarction," Huang He said. The team's strengths come from continuous innovation in three areas: optimizing drug regimens, innovating device therapy, and improving the treatment system. Taking device innovation as an example, while ensuring surgical safety and success rate, the team has committed to developing transradial coronary intervention for acute myocardial infarction, constantly challenging established taboos. It has achieved not only routine transradial intervention for mild to moderate heart attack patients but has also successfully applied the technique to critically ill patients, reaching internationally advanced levels.

From "Following" to "Leading": Individualized Atrial Fibrillation Care Across the Whole Life Cycle

Arrhythmias, including atrial fibrillation (AF), are the second most common conditions admitted by the Sir Run Run Shaw Hospital Cardiology Department. In 2024, the department performed more than 4,300 arrhythmia ablation procedures.

Dr. Jiang Chenyang, deputy director of the Department of Cardiology and director of the Atrial Fibrillation Center at Sir Run Run Shaw Hospital, explained that typical AF symptoms include palpitations, chest tightness, shortness of breath, frequent urination, and the anxiety and depression these can cause. Some AF patients have no symptoms at all and are only found during check-ups. Yet even without symptoms, long-term AF readily leads to serious complications such as heart failure, stroke, and cognitive impairment.

"As early as the late 1990s, we began paying attention to AF and became one of the first units in China to perform AF catheter ablation. We were also the first in Zhejiang Province to be equipped with a three-dimensional cardiac electrophysiology mapping system," Jiang Chenyang said. As AF ablation became routine, the team advanced rapidly. Jiang Chenyang himself became one of the top surgeons in China within a few years, one of the few doctors in the country who could complete the procedure within an hour at the time. In 2015, one of the team's research achievements was published, with Jiang as second author, in the top medical journal The New England Journal of Medicine.

Jiang Chenyang noted that, guided by a "patient-centered" philosophy, the team provides individualized AF treatment plans while placing special emphasis on whole-life-cycle care. "AF is an age-related disease. Even if this catheter ablation is very successful, as the patient ages, AF may recur or reappear in the future, especially when risk factors such as hypertension, alcohol use, diabetes, obesity, and sleep apnea are not well controlled." To this end, the team has built multiple channels of connection with patients. Besides regular follow-up reminders and clinic visits, nearly 50 WeChat groups have been set up to answer patients' everyday questions for free and to hold monthly online health-education talks. This whole-life-cycle care concept has become a major highlight of electrophysiology at Sir Run Run Shaw Hospital.

Today, the annual number of AF ablations at Sir Run Run Shaw Hospital ranks among the highest in China. In catheter ablation, while closely tracking cutting-edge technologies at home and abroad, the department is not content merely to be a "follower." It conducts multidimensional, comprehensive research into the pain points and challenges of the AF field, transforming from "following" to "leading." It is a national leader in green electrophysiology (radiofrequency ablation performed without X-rays) and one of the most experienced institutions in the world for AF catheter ablation. It was the first in the country to apply intracardiac echocardiography instead of transesophageal echocardiography in clinical practice, significantly shortening hospital stays and improving patient experience. And it was the first in the world to propose a combined endocardial-epicardial ablation strategy, markedly improving the success rate of surgery for refractory AF.

"Particularly noteworthy is that last year, in collaboration with Beijing Anzhen Hospital, we published a study in the top international medical journal JAMA, for the first time in the field of electrophysiology, proving that linear ablation plus pulmonary vein isolation can improve the success rate in persistent AF. It caused a sensation in the field and is expected to change the guidelines on AF catheter ablation," Jiang Chenyang said.

Selected as One of the First 12 National Cardiac Valve Disease Interventional Centers

As China's population ages, the incidence of heart valve disease rises year by year. The development of minimally invasive interventional therapy has brought new hope to such patients.

"Heart valves are one-way valves that keep the heart working in an orderly way. Their diseases include stenosis and insufficiency," Fu Guosheng explained. Stenosis of the aortic valve, the heart's most important valve, is the most common, often degenerative and combined with severe calcification, which can be simply understood as wear caused by frequent opening and closing. Such patients are mostly elderly, with stenosis and often complex underlying diseases, leaving very few opportunities for open surgery. However, transcatheter minimally invasive surgery offers small trauma, fast recovery, and an outcome no worse than, or even better than, open surgery. He particularly emphasized that aortic insufficiency comes in primary and secondary forms. Unlike aortic stenosis, because of the heart's strong compensatory capacity, even patients with a greatly enlarged heart may have no symptoms or only mild ones. But once symptoms appear, it means severe heart failure, and the patient's condition declines sharply, often missing the surgical window. In the past, surgery had limited effect on the primary disease and the results were often unsatisfactory. Now the transcatheter minimally invasive approach is used to solve the problem. Because of the small trauma and fast recovery, patient acceptance is higher, the treatment rate rises, and long-term prognosis improves greatly. After surgery, patients' cardiac function can recover well.

To date, the Sir Run Run Shaw Hospital Cardiology Department has completed nearly 700 transcatheter aortic valve replacement (TAVR) procedures and more than 120 transcatheter mitral valve repair (TMVR) procedures, making it one of the most experienced centers in China. In both quality and quantity it ranks among the top in Zhejiang Province and indeed the whole country.

In 2023, the Sir Run Run Shaw Hospital Cardiology Department became one of China's first 12 national cardiac valve disease interventional centers, opening a new era of interventional treatment for structural heart disease. The team keeps breaking through technical bottlenecks, performing a range of cutting-edge techniques such as TAVR and transcatheter mitral/tricuspid edge-to-edge repair, and providing safe, effective minimally invasive options for more elderly valve disease patients and high-surgical-risk patients. Notably, for transcatheter aortic valve replacement in cases of insufficiency, the team has developed a personalized surgical method based on precise preoperative evaluation and intelligent algorithms, making the procedure safer and more effective.

Last year, the project "Transcatheter Interventional Valve for Severe Aortic Regurgitation," led by Professor Fu Guosheng, was selected for support under Zhejiang Province's "Elite" R&D Program. It has now entered the animal-experiment stage, promising to bring more options and hope to patients.