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Sunday, September 28, 2008

External pump for heart disease

Q: I am under treatment for angina. When I have an attack of chest pain, I usually can get rid of it with nitroglycerin. My neighbor, exactly my age, has the same thing: coronary artery disease with angina attacks. His doctor is treating him with leg pumps. He says he has had no angina since he started the treatment. Would this help me?

A: The procedure, enhanced external counterpulsation, has been around for 10 years.

A series of cuffs, like blood pressure cuffs, is wrapped around the patient's legs. At a very precise moment in the heart cycle, the cuffs are sequentially inflated, with the lowest cuff inflated first. The pumping maneuver increases blood flow back to the heart and to the heart muscle. Angina is chest pain that comes on with activity. It indicates that one or more of the heart arteries have a blockage. People with artery blockage get enough blood to the heart muscle when they're resting, but, when they are active, the blockage prevents the increased flow required for the extra effort the heart must make. The result is the chest pain called angina.

Some people who have undergone a series of EECP treatments have fewer attacks after the treatment, and some have even discontinued medicine for angina.

EECP has yet to win universal approval. People who judge the effectiveness of medical treatments want more evidence before they recommend it for everyone. Would it work for you? Only a trial with it will tell you.

Q: There's a yellow streak on both my eyelids. What is this? Does it mean eye trouble?

A: Those streaks are xanthelasmas (ZANN-thul-AS-muhs), an aggregation of cells filled with cholesterol. In half of people with them, they indicate high blood cholesterol or high blood triglycerides. If you haven't had a check of your cholesterol or triglycerides, you should have one.

They are not a sign of eye trouble. If you find them cosmetically distressing, they can be removed.

Q: What's a "chemical" depression? I have two relatives who say that's what they have.

A: Brain cells communicate with each other through chemicals with names such as dopamine, serotonin and norepinephrine. One current and popular theory about depression cites an imbalance of one or more of these chemicals as the cause. Antidepressants restore the normal balance.

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1 Comments:

Blogger Unknown said...

You can find EECP providers at eecp.com - go to "Locate Treatment" and type in your zip code - it will pull up the 5 locations closest to you.
EECP has been studied and proven effective in 75-80% of patients suffering from angina. It’s reimbursed by CMS and FDA approved for treatment of both stable and unstable angina among other conditions.
The following types of patients are eligible for and may benefit from EECP:
- Your medications no longer relieve your angina
- You restrict activities to avoid symptoms
- You’re unwilling or can’t undergo additional invasive revascularization procedures such as bypass or angioplasty
- Have LV dysfunction (EF<40%), ischemic cardiomyopathy
- Have other conditions that increase the risk of revascularization procedures such as:
- diabetes
- heart failure
- pulmonary disease
- renal dysfunction
- You’re considered inoperable or at high risk of operative/interventional complications
- You have microvascular angina (Cardiac Syndrome X)
- Diabetic patients known to be at greater risk for post-procedural complications
- Elderly patients at high risk for morbidity/mortality from angioplasty or bypass

September 29, 2008 at 7:36 AM

 

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