EECP - Treatment option for angina By Tim Malling, M.D., PAHCS What is angina? Angina is a condition of chest pain caused by the heart not getting as much blood flow as it needs. It is usually caused by blockages of the blood vessels in the heart and is brought on by physical activity. The heart needs more blood flow when it is working harder, but can't get it because of the narrowing of the vessel supplying the blood. Because of this, the person may feel chest pain, pressure, neck or arm pain, or sometimes other symptoms that are brought on by activity and get better with rest. What can be done to treat angina? There are basically four treatment options. 1) Medical management using medicines to help lower the heart rate, lower blood pressure, and open up blood vessels a little. These options help to decrease the work that the heart muscle has to do, and improves the blood flow slightly. 2) Bypass. This is basically "open heart surgery" and involves putting new blood vessels in to go around blockages. 3) Angioplasty. This is a procedure done through the big blood vessels in the groin. It involves using balloons and sometimes stints to open up tight blood vessels on the heart surface. 4) EECP. What is EECP? EECP stands for Enhanced External Counterpulsation and is a treatment option that can nonsurgically improve blood flow to the heart muscle. It involves 35 one-hour treatments, usually done one hour a day, five days a week, for seven weeks. The procedure was actually developed 35 years ago as a treatment option for angina, but fell out of favor when the "quick fix" options of bypass and angioplasty became available. It was used for a wide variety of medical problems in China since then, and is now starting to appear in the United States as a viable treatment option for angina. The heart gets its blood flow in between beats, when the blood flows back against the closed aortic valve and into the coronary (heart) arteries. EECP involves the use of compression balloons on the legs that rapidly inflate in sequence to force blood back up into the heart muscle between beats. This stimulates the heart muscle to grow new blood vessels, improving blood flow. Patients usually experience more energy, less chest pain, and less use of medications to control their symptoms. EECP has been shown to be as effective as bypass or angioplasty, and studies out to five years after treatment show continued benefit. The treatment works for 70-80 percent of patients, and is FDA approved and covered by Medicare. It is offered here in Paynesville, two places in the Twin Cities, and in Rochester. Some patients get skin breakdown for the balloons inflating, and require special padding. Some patients also experience some leg and low back pain early in the treatment cycle, but this gets better with time. EECP is not for everyone, but does offer an excellent treatment option for many. Certain medical conditions such as aortic valve problems, heart rhythm problems, or severe blood flow problems to the skin of the legs make the treatment much less effective. If you suffer with angina, ask your health care provider if EECP is an option for you. Return to Newsletter