Can Heart Failure Be Reversed?

Heart failure is one of the top killers in the United States, claiming about 380,000 lives every year.

But while the disease can be severe and life-limiting, it doesn’t always get worse—and can even be reversed, says cardiologist Robert Berkowitz, M.D., who specializes in heart failure and transplant cardiology at Hackensack University Medical Center.

Heart failure is characterized by the organ’s inability to pump blood efficiently through the body. Although it can worsen over time, an ever-expanding choice of medications and surgical treatments has transformed the diagnosis from a death sentence to a chronic condition that won’t necessarily progress. 

“It used to be that once you had a diagnosis of heart failure, you were going to die in three to four years. Now, it’s completely reversible in many cases,” explains Dr. Berkowitz, who founded Hackensack’s Heart Failure Program in 2000. “We have patients in our program who, many years later, are living a wonderful life.”

Mainstay Treatments

The chances of stalling or reversing heart failure are far better for those who seek early treatment, Dr. Berkowitz notes. While all therapies seek to relieve major symptoms such as shortness of breath, fatigue and swelling in the legs and abdomen, they also aim to slow disease progression and keep patients out of the hospital.

But treatment options depend on how severe your case is, he says. Most patients benefit from three types of prescribed drugs considered mainstays in heart failure care:

1. Beta blockers, which block excess adrenaline production that can damage heart cells
2. ACE inhibitors (or ARBs), which help relax blood vessels to lower blood pressure
3. Aldosterone inhibitors, which block a hormone that promotes heart failure symptoms by triggering salt and fluid retention

“All three medications block hormonal reflexes that can do a lot of damage,” Dr. Berkowitz says, adding that lifestyle measures such as eating a low-sodium diet are also important. “Once we block them, the heart starts getting stronger.”

Extreme Heart Failure Options

Even for the 1 in 10 patients coping with extreme heart failure, the condition can still be reversed for some, Dr. Berkowitz says.

That may require:

• Implantable heart pump
• Heart reconstruction procedure
• Heart transplant 

Regardless of whether that’s possible, almost all heart failure patients require ongoing medication usage and regular follow-ups with a cardiologist.

“The mark of good therapy is treating both your symptoms with medications and treating your heart so it gets better,” Dr. Berkowitz says. “If you’re treating the underlying problem, it gives you a chance of a full recovery.”

Next Steps & Resources:

• Meet our source: Robert Berkowitz, M.D. To make an appointment with Dr. Berkowitz, call 800-822-8905 or visit our website.
• Learn more about comprehensive cardiac care close to home at Hackensack Meridian Health