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 - Northwestern Memorial Hospital - Chicago

Cardiac Behavioral Medicine

The Cardiac Behavioral Medicine service was created with the understanding that the mind and body (the heart, in particular) influence each other. The most obvious example of this mind-body connection can be seen in the risk factors for heart disease, most of which can be reduced by altering our behaviors (e.g., increasing exercise, eating a heart-healthy diet and quitting smoking). Our lifestyle behaviors directly influence our heart health. Changing long-standing behaviors, however, can be difficult. Barriers to change often include:

  • Limited motivation
  • Reduced confidence from prior attempts at change
  • Stress
  • Emotions
  • Minimal support
  • Limited time and resources
  • Vague plans about how to proceed.

Our emotions and personality can also impact our cardiac health. Depression, stress, anxiety, hostility and limited support can increase an individual’s risk of developing a heart condition and can worsen the outcome after a cardiac event. For example, some medical studies have found that depressed individuals are 2 to 4 times more likely to develop coronary artery disease than non-depressed persons. Our physiological reaction to stress also can cause wear and tear on the cardiovascular system, ultimately impacting blood pressure, inflammation, coronary artery disease, cardiac events, and arrhythmias. In sum, our emotional health and our lifestyle behaviors influence our heart health.

The reverse also is true—heart health can impact our emotions and stress levels. A cardiac event or diagnosis can trigger symptoms of depression, anxiety, fear or stress. In fact, 20 to 40 percent of patients with coronary artery disease may exhibit symptoms of clinical depression, particularly after a heart attack or after open-heart surgery. Medical studies have repeatedly found that cardiac patients with depressed symptoms are more likely to have poorer medical outcomes. Depression also makes it more difficult to stop smoking, lose weight and take medication properly, which can negatively impact cardiac health. In fact, the American Heart Association now recognizes depression as a risk factor for poor cardiac outcomes in patients with coronary artery disease. Some patients with coronary artery disease become sensitive to noticing physical sensations in their body, particularly after a heart attack or a cardiac event, which can lead to anxiety or panic. Avoidance of certain people, activities or situations due to anxiety or fear of heart symptoms suggests that the anxiety is debilitating and likely warrants medical attention. Changes in sleep, appetite, concentration, and diminished interest in pleasurable activities may suggest depression, anxiety or emotional distress. Identifying and treating the emotional consequences of a cardiac event are important for optimizing the quality of a person’s life and to help maintain the best heart health possible. Therefore, please discuss any changes in mood or stress with your cardiology team.     

Cardiac treatment is most successful when it focuses on the physical, emotional and behavioral health of the patient. Northwestern Memorial Hospital’s Center for Coronary Disease at the Bluhm Cardiovascular Institute offers Cardiac Behavioral Medicine services that include comprehensive care in the evaluation and treatment of coronary disease by addressing the emotional and behavioral components. Cardiac Behavioral Medicine helps patients and their families adjust to a diagnosis of heart disease and provides support for patients who require cardiac surgery. Patients are educated about the role of emotions and stress in their cardiac health. They are taught new ways of relaxing and coping so that their heart is not harmed by daily stress and hassles. Lifestyle behavior changes are tackled in a supportive setting to help patients achieve their goals of quitting smoking, losing weight or adhering to a new exercise regimen.

Kim L. Feingold, PhD, director of Cardiac Behavioral Medicine, Gail M. Osterman, PhD, and  Anjannette Padilla Ryan, PhD candidate and post-doctoral fellow, specialize in helping cardiac patients adjust to a diagnosis and become more resilient throughout the course of treatment. Their techniques include strategies that facilitate behavior change, improve coping strategies, minimize stress and correct faulty ways of thinking, like those associated with hostility or perfectionism.

Cardiac Behavioral Medicine is helpful for a variety of presenting issues, including:


To schedule an evaluation or inquire about services regarding Cardiac Behavioral Medicine through the Bluhm Cardiovascular Institute, please call 312-695-4965.

Last UpdateDecember 2, 2011