Brought to you by Penn Medicine Heart and Vascular Center

Finding Hope After a Diagnosis

Heart disease is serious, but it’s also more treatable than ever before. Penn Medicine’s Joyce W. Wald, DO, says new cutting-edge treatments and therapies are helping patients with advanced heart failure extend their lifespans, live more comfortably and, in some cases, even reverse their heart disease.

What led you to focus on advanced heart failure? My mom is a physician and my identical twin sister is also a cardiologist in the Lehigh Valley, so medicine runs in the family. In medical school, my sister and I had a wonderful cardiologist professor who became a mentor and made me con-sider the field more seriously. Likely many kids in our class went into cardiology because of him. And it’s a fascinating field—you can really help people both prevent disease and, if they develop end-stage heart failure, increase their lifespan.

What is a common misconception people have about heart disease? The biggest one is that if someone is diagnosed with heart failure it’s a death sentence. In reality, we now have so many medications that can help reverse heart disease and improve heart function. There are also many clinical trials underway at Penn Medicine and elsewhere with some very promising treatment protocols and devices. And of course, heart transplantation is a wonderful gift of life for certain patients with refractory heart failure.

Are there any new devices that are changing treatment outcomes for your patients? The technology behind our mechanical heart pumps (or ventricular assist devices, VADs) is getting better and better. The newest generation of devices have less risk of stroke or clotting, and they’re also smaller, which can be helpful for women who tend to be smaller than men. We also now have CCM (cardiac contract modulation), which is a small device similar to a pacemaker for patients who have weak heart muscle and continue to have symptoms despite aggressive therapy and who do not fit the criteria for cardiac resynchronization therapy. CCM can work along with their medications to help them feel better.

Most of your patients have advanced-stage heart failure. What are some of the factors that caused them to get to that point? Women are so used to being caregivers that we often put our health last. But for us to be able to take good care of the rest of our families, we have to also prioritize our own health care. Women may also present differently than men, and their symptoms can sometimes be brushed off as anxiety, and their disease is then caught later on when it’s more advanced. Women have to be good stewards of their own health. You know your body best, so be persistent in getting the care you need.

Do you have any advice for helping women advocate for themselves? You should feel emboldened to get a second opinion. There are people who don’t want to hurt the feelings of, or doubt, their primary physician. But if you feel like something is wrong and you’re not being heard, you deserve to get a second opinion. And if you do receive a heart disease diagnosis, make sure that you advocate for yourself—don’t be shy in getting the answers that you need! You should feel empowered to educate yourself about your disease along with trust-ing your medical team.