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Finn Waagstein on the importance of following the heart

Finn Waagstein was declared a reckless doctor and mocked by the international academic community. But instead of giving up he continued to promote his unusual theory of treating heart failure with beta blockers. He followed his heart and subsequently saved thousands of others. In time, he came to set a new standard for how to treat heart disease.

In the mid-1970s, the prevailing view was that a weak heart should be stimulated. In Gothenburg one young doctor had the opposite theory. When Finn Waagstein sent his first article on beta blockers to the British Heart Journal, his supervisor felt obliged to attach a covering letter. It began with the words: “This man is not completely insane”.

“British Heart Journal sent back a three-page reply saying that they had met several times and decided that it was worth publishing, even though the content seemed rather odd,” explains Finn Waagstein.

Harsh criticism from the world at large
It would take more than a decade before the world really started to listen. Initially, Finn Waagstein and his colleagues were harshly criticised, especially in the UK.

“Professors wrote editorials in the Lancet about ‘the perverse Swedish cardiologist’ who gives beta blockers to patients with heart failure and risks taking their lives. And they were strong people with a great deal of influence,” says Finn Waagstein.

Following his conviction
But at home the young Gothenburg doctor had support. Both the management and his colleagues backed him up and Finn Waagstein decided to continue.

“Even the nurses at the ward supported me. Every time a patient got better, we believed more in what we saw with our own eyes than what the critics thought.”

A chamber of horrors
Finn Waagstein conducted the first experiments with beta blockers on his own accord.

“It would not have been possible to do so today, but it’s important to understand how cardiac care looked in the mid-1970s. Mortality was almost 50 per cent. The heart attack patients lay in a room in a regular medical ward with only drapes between the beds, hearing their neighbours receiving cardio resuscitation. It was like a chamber of horrors.”

“Some patients with acute cardiac infarction and a high pulse also had acute heart failure. Lacking other treatment methods, I tested my beta blocker theory. They received an intravenous dose without worsening the heart failure. On the contrary, we were able to see that pain was reduced and the ECG changes subsided,” explains Finn Waagstein.

The rest is history
Finn Waagstein and his colleagues conducted a number of smaller studies on selected patients with chronic heart failure and high pulse – and were able to show a clearly improved heart function after 6-12 months. But resources were too scarce for a large controlled study.

This forced Finn Waagstein to make a drastic decision.

“I simply applied beta blockers to a group of patients and showed that they got better. Then I took away the treatment and could show that they all got worse. Of course it was risky, but it was necessary in order to convince the world that it really was effective. The results of the study were published in 1989. This sparked interest in the US. We conducted a joint study and the rest, as they say, is history.”

Finn Waagstein

PhD at University of Gothenburg, 1976. Professor of Cardiology in 1999.

Selection of appointments and awards

  • European Society of Cardiology – silver medal
  • King Faisal International Prize – gold medal
  • Lars Werkö Prize
  • Lifetime Achievement Award from the Heart Failure Association
  • Appointments to the European Society of Cardiology
  • External adviser to the German Research Foundation
Page Manager: Pontus Sundén|Last update: 8/8/2018

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