External Counterpulsation and method of minimizing end diastolic cardiac external counter pulsation angina therapy-external counter therapy
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External Counterpulsation and method of minimizing end diastolic cardiac external counter pulsation angina therapy-external counter therapy
   For the Doctors
 
External Counterpulsation and method of minimizing end diastolic cardiac external counter pulsation angina therapy-external counter therapy
   For the Patients
 
  External Counterpulsation and method of minimizing end diastolic cardiac external counter pulsation angina therapy-external counter therapy  
Q. What are the benefits of ECP treatment ?
Ans As mentioned before, there are numerous benefits gained from a course of ECP. Some of them are :
  • Reduction or elimination of angina chest pain.
  • Resolution of reversible ischemic defects.
  • Improved exercise treadmil times (50% of patients have doubled their exercise toleration after just one round of treatments!)
  • Reduction or elimination of the need for nitroglycerin medications.
  • Ability to enjoy a more active lifestyle!
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    Q. If ECP works so well, why haven't I heard about it before?
    Ans For a few reasons... First of all, as mentioned before the FDA only approved the procedure as an accepted medical treatment two years ago. Since then we are working hard to let every heart patient know that there is an alternative to surgical interventions in the treatment of heart disease. Because ECP provides patients an opportunity to stay away from invasive surgery, it is precisely the reason you should not expect to hear too much about this safe and effective alternative from your regular cardiologist. However, many cardiologists are beginning to realize that their patients know about this alternative anyway, and are recommending ECP as a non-invasive natural bypass procedure, in patients that are high risk for surgery or have no other alternatives.
       
    Q. How do I know if I'm a candidate for ECP ?
    Ans. Following type of heart patients suffering from Angina, Myocardial Infarction (Heart Attack) and congestive Heart Failure benefit from ECP :-
  • Who suffer even on maximum medicines.
  • Who are not fit for angioplasty or bypass surgery.
  • Who do not want angioplasty or bypass surgery
  • Cardiogenic shock.
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    Q. What are the things that would prevent me from being a candidate?
    Ans. There are a few contraindications for treatment :-
  • Recent aneurisms.
  • Uncontrolled cardiac arrhythmias (or very irregular heartbeats).
  • First 3 months following open-heart surgery.
  • First 2 weeks following cardiac catheterization.
  • Recent blood clots in the legs.
  • Blood pressure greater than 180/110 will need to be lowered first.
  • Aortic valve insufficiency.
  • Pregnancy.
  • Liver Failure.
  • Severe phlebitis, or extremely poor circulation in the legs, will need to be treated first.
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    Q. Doesn't the inflation of the cuffs put added stress on my heart ?
    Ans. On the countrary, your heart is the MOST relaxed it can be while you are on the ECP machine. The reason for this is that the cuff inflation not only expands your coronary arteries, but it helps the heart to fill when it is in relaxation. Then, when the heart begins to pump the cuffs deflate, creating a vacuum effect or a lower-pressure system for the heart to pump into, thereby decreasing the cardiac load, and decreasing the work your heart has to do!
       
    Q. Will ECP clean out my arteries ?
    Ans.

    The procedure does not remove any blockages you have, per se, but rather grows new collateral vessels around them. In that way ECP creats these "natural bypasses" So instead of taking a vessel out of your leg, cutting your chest open and grafting this vessel onto your heart, ECP allows your heart to grow new vessels naturally, and non-invasively.

    That said, however, new studies are beginning to look at all the benefits of ECP in increasing the circulation everywhere in the body, not just in the heart.

    What will clean out your arteries is to start on a healthy diet and exersixe regimen and change some of the lifestyle patterns that elogged up those arteries in the first place. At the ECP Heart Care Center our treatments are augmented by an entire health information and lifestyle assessment package.

       
    Q. Sounds too good to be true. Are there any risks associated with ECP ?
    Ans. The only risk (other than for patients who have symptoms included on the list of contraindications which would prevent you from receiving treatment in the first place) is for those with very fragile skin on their legs. Some of these patients have experienced some minor skin irritation due to the pressure of the cuffs. If that is the case there are some things we can do to minimize some of the friction of the inflation and deflation of these cuffs.
       
    Q What does ECP do ?
    Ans. The ECP Effects :-
  • Small blood vessels of the heart enlarge.
  • Dormant blood vessels (present since birth but which remained closed) open up.
  • New blood vessels are formed.
  • These shunt blood from regions with good blood supply towards area with inadequate circulation and hence this collateral blood flow is like a "physiologic Coronary bypass" or "natural bypass".
  • The plaque gets stabilized & compressed with repeated counter pulsation.
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    Q. How is ECP done ?
      Principle of Action
  • Specially made inflatable balloon cuffs are wrapped to the extremities.
  • Cardiac QRS wave is used as the signal for controlling the system.
  • Compressed air sequentially fills the cuffs-the two calves and arms, the two legs, and then the buttocks.
  • By compression of the arteries, blood flow during the diastole is concentrated in the upper part of the body-diastolic pressure at the early and middle stage is significantly increased but within the safety range.
  • The blood flow volume increases.
  • Just before systole negative suction pressure is applied.
  • There is hastened discharge of air in the cuffs.
  • Compressed artery is thus immediately released with decreased after-load.

  • The cuffs are attached to air hoses that connect to valves that inflate and deflate the cuffs electronically synchronized with the heartbeat. Patients experience a sensation of strong "hug" moving upward from the calves to thighs to buttocks during inflation.

       
    Q. Will angiography or stress thallium show improvement ?
    Ans. The blood flow of the heart muscle is not proportionate to the degree of narrowing in a coronary artery. Angiography is dont to see the narrowing in large coronary vessels. It is extremely suitable to identify stenosis, which is essential for angioplasty and bypass surgery. However angiography cannot visualize small arteries like arterioles and capillaries and cannot assess overall blood flow in a particular area of heart. For this purpose Stress Thallium and Cardiovascular Cartography are required. Improvement with ECP has also been documented by Stress Thalluim Test.
       
    Q. How do I know how it works ?
    Ans. Your body knows you better than anyone else
  • After initial 5-10 sittings, the chest pain frequency and intensity reduces significantly in a majority of patients.
  • Exercise tolerance improves significantly as experienced by the patient during morning walks and while climbing the stairs.
  • ECP has even worked in cases where bypass surgery or angioplasty has failed or has not been successful.

  • More objective difference can be seen by going for 'Stress Thallium Test' before and after the treatment. There is marked improvement in the oxygen supply to the heart, as revealed by this test.
       
    Q. What are the Symptomatic Relief due to ECP treatment ?
    Ans.
  • Reduced frequency and intensity of chest pain.
  • Reduced need for medication.
  • Increased exercise tolerance.
  • Overall improvement in the quality of life.
  • Improved sense of well-being.
  • Improved sleep at night.
  • Majority of the patients feel more alert and mentally focused with increased energy, more vitality and overall improvement in the quality of life and improved family life.
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    Q. What is the total duration of the treatment ?
      This is only 35 hours treatment
  • One hour a day, 6 days a week for 6 weeks. OR
  • Two sessions in a day (with a gap of at least 4 hours), 6 days a week for 3 weeks.


  • No hospital stay required
       
       
     
         
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