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Why do I get chest pain?

Cheat pain is caused by gradual blockage of the coronary arteries. The narrowed or blocked arteries restrict blood flow to the heart muscle. Your heart gets oxygen and nutrition from the blood tat flws through these arteries. prior to 1997 the options to treat your chest pain were limited to Medication, Angioplasty, Bypass surgery. Now a new treatment called EECP is introduced which has been approved by F.D.A. U.S.A.

What is Enhanced External Counterpulsation?

EECP is the first nonsurgical, non-pharmaceutical, mechanical treatment for patients with chest pain and heart failure. It helps to increase blood flow to the heart muscles deprived of adequate blood supply. The beneficial effect obtained after the completion of treatment persists for years together.

Why do I get chest pain?

EECP is the first nonsurgical, non-pharmaceutical, mechanical treatment for patients with chest pain and heart failure. It helps to increase blood flow to the heart muscles deprived of adequate blood supply. The beneficial effect obtained after the completion of treatment persists for years together.

Why there is a need for another treatment?

Despite the advances in cardiology in treatng chest pain and heart failure the problem still persists. Drugs do not always provide relief and invasive procedures have their own associated risk factors. EECP can provide the patients with all the advantage similar to that of medication and symptom relief comparable to that of invasive procedures without undergoing them.

What does EECP treatment include?

In an EECP session, the patient  lies on a padded table. Three large inflatable cuffs-similar to blood pressure cuffs-are strapped around the calves, lower thighs and upper thighs. The patient's heart is monitored by an electrocardiograph display in the machine, which through the computer regulates the inflation and deflation of the cuffs. During the part of the cardiac cycle when the heart is at rest (diastole), the cuffs are rapidly inflated in sequential order beginning with the cuffs at the calves and working upward. Just before systole (heart contraction), the cuffs are simultaneously deflated.

How long does the treatment take?

EECP involves 35 days of treatment . Each treatment session is for one hour and the patients are asked to come six days a week for six weeks. It is very important that the patient adhere to the one-hour time schedule fixed by the hospital or medical center and the patient is expected to continue the treatment with out break.

What is collateral circulation?

Formation of network of tiny blood vessels, which make it possible for blood to detour around blocked or narrow arteries, is called collateral circulation. However the development of collateral circulation is a gradual process and not everyone has the same ability to develop these networks at the rate that will relieve angina. EECP treatment triggers and accelerates this collateral circulation and makes it permanent.

How does EECP treatment work?

EECP increases the blood flow to heart muscles. The increase in blood flow to the area of heart muscle not receiving enough blood suply is achieved by two means by EECP treatment (1) Forming new vessels around the blocked artery. (2) Because of increase blood flow and pressure during EECP there is high pressure in open coronary arteries and lower pressure in closed arteries. Blood finds its way to the low pressure zone or area, whch has decreased blood supply by opening the collaterals. These collaterals eventually become permanent.

Does EECP give symptom relief as Bypass and Angioplasty?

All these current mode of treatments help the heart by increasing the blood flow to the area of the heart muscle not receiving adequate blood supply. Once the blood supply is increased towards normal the patient's chest pain will be decreased or eliminated and his exercise tolerance will improve.

How do Bypass, Angioplasty and EECP help in relieving chest pain?

 

In bypass surgery the diseased section of your coronary artery are bypassed with healthy artery or vein to increase the blood flow to the ehart muscle area. once the blood flow is restored chest pain may be reduced or eliminated.


Bypass Surgery

Before
After
Decreased blood flow
Normalized blood flow

Angiolasty

 
In angioplasty an inflatable balloon is introduced inside the obstructed coronary artery and the balloon is inflated once it is positioned inside the artery. The obstructed part is pressed against the vessel wall and the blood flow is restored.

EECP Treatment

 
During EECP hearts natural mechanism of forming new vesel is enhanced which markedly increase the blood supply to the heart muscle. EECP also tends to improve your endothelial cell function that lines your coronary arteries, which determine your chance of getting heart attacks. EECP decrease your heart rate and other deleterious Neurohomones, which dmge the heart muscles.
Decreased blood flow
Normalized blood flow

How do I personally know the treatment has helped me?

*Patient can walk more distance without chest pain
*Patient would have fewer or no angina
*Episodes of angina would be less painful
*Patient need for anti-anginal medications can be reduced
*Patient can return to work and can participate in their active life style once again
*Patient would be more energetic and confidence

Do I need any investigation to be done after the treatment?

Some patients want to visualise the post EECP treatment improvement when compare with their previous reports. They can repeat their Exercise treadmill test or Echo cardiography or Nuclear scan after the treatment. Some physician might feel follow-up test is unnecessary since the patient symptomatic clinical improvement itself has demonstrated increase blood flow to the heart muscle.

Do I need anything special to prepare myself fo the treatment?

EECP is a safe, out patient , non-invasive treatment . So you don't have to restrict any of your daily routine work. You can fix your one-hour time treatment schedule according to your convenience. Before you start the treatment you will asked to wear tight fitting elastic pants. This is to prevent skin irritation and abrasion.

*Avoid taking food two hours before the treatment.
*Empty your bladder before starting the treatment.
*If you are taking any diuretic medication avoid taking them before the treatment.
*Continue your regular medication as prescribed by your physician.

Is EECP a replacement for Bypass or Angioplasty?

EECP is not considered a replaceent for coronary artery bypass surgery or baloon angioplasty instead EECP may delay the need for these invasive procedures. In many cases, relief will be sufficient to render them unnecessary. EECP is also used in patients who have already undergone surgery or angioplasty but not getting sufficient relief of their symptoms.

What should I do after EECP treatment?

To prevent the progession fo your disease after  completion of the treatment you should make life style changes like

*Quitting smoking *Following heart friendly diet *Controlling obesity * Doing Regular exercise.

Have regular follow up with your cardiologist to lower your cholesterol, to control your blood pressure and diabetes. EECP treatment provide you with new blood vessels. It is you to prevent your vessels from developing obstruction again.

EECP ADVANTAGES OVER SURGERY
EECP has numerous distinct advantages over surgery:
*Noninvasive *Outpatient *Lowrisk
*No additional Medication required
*No side effect
*Patients have reported increased exercise tolerance energy and free from chest pain folowing treatment without risk of surgery.

 

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