November 24, 2021
Clinical contributors to this story
Robert Berkowitz, MD contributes to topics such as Heart failure and cardiology transplantation.
Heart failure is one of the leading killers in the United States, killing an estimated 380,000 people each year. But while the disease can be serious and life-limiting, it doesn’t always get worse and can even be reversed, says cardiologist Robert Berkowitz, MD, who specializes in heart failure and transplant cardiology at Hackensack University Medical Center. .
Heart failure is characterized by the organ’s inability to effectively pump blood around the body. Although it can worsen over time, an ever increasing choice of drugs and surgical treatments has turned the diagnosis of a death sentence into a chronic illness that will not necessarily progress.
“Previously, once you were diagnosed with heart failure, you were going to die in three or four years. Now it’s completely reversible in many cases, ”says Dr. Berkowitz, who founded the Hackensack Heart Failure Program in 2000.“ We have patients in our program who, many years later, are leading a heart failure program. wonderful life.
The chances of stalling or reversing heart failure are much better for those seeking treatment early, notes Dr. Berkowitz. While all of the therapies are aimed at relieving major symptoms such as shortness of breath, fatigue, and swelling in the legs and abdomen, they are also aimed at slowing the progression of the disease and preventing patients from going to the hospital.
But the treatment options depend on the severity of your case, he says. Most patients receive three types of prescription drugs considered to be the mainstay of heart failure care:
- Beta blockers, which block excess production of adrenaline which can damage heart cells
- ACE inhibitors (or ARBs), which help relax blood vessels to lower blood pressure
- Aldosterone inhibitors, which block a hormone that promotes symptoms of heart failure by triggering salt and water retention
“All three drugs block hormonal reflexes which can do a lot of damage,” says Dr Berkowitz, adding that lifestyle measures such as a low sodium diet are also important. “Once we block them, the heart starts to get stronger. “
Extreme heart failure options
Even for 1 in 10 patients with extreme heart failure, the situation may still be reversed for some, says Dr. Berkowitz.
It may require:
- Implantable heart pump
- Cardiac reconstruction procedure
- Heart transplant
Regardless of whether it is possible, almost all patients with heart failure require continued use of medications and regular follow-ups with a cardiologist.
“The hallmark of good therapy is to both treat your symptoms with medication and to treat your heart to get better,” says Dr. Berkowitz. “If you treat the underlying problem, it gives you a chance to make a full recovery. “