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PostPosted: 02 Dec 2016 18:53 
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This was posted in IMA CGP WhatsApp journal by a member (name was not published)

Do you think the following treatment works in all cases?

Recently, one person was admitted to a nursing home at Ahmedabad, due to severe chest pain. He had an earlier heart attack in 2015 and was under treatment. The doctors now suggested Angiography.

Upon undergoing Angiography at multi speciality Hospital Doctors diagnosed multiple blockages for which Angioplasty was ruled out and instead, suggested 'Bypass Surgery'.

That evening, he was brought home as doctor suggested his heart being very weak,due to pumping loss bypass could be performed only after 10 - 15 days.

Meanwhile, after discussing the matter with relatives and close friends, fresh information came from a family friend.

A new treatment known as-"Enhance External Counter Pulsation" has been introduced into the Indian medical scenario which has got US FDA approval and successfully opted in many country.

With this therapy, a patient who has to undergo by-pass need not to do so.

Instead, the patient is given EECP treatment for 35 days in which a machine opens heart's collateral so natural bypass done.
Cost per seating is Rs.2500/-

Currently, only a few doctors in India specialise in this field

One of them is DR. Bimal Chhajer MBBS MD Ex Consultant AIIMS.He had started 60 centers. all over India with their expert. Team.

He has a list of patients who had to undergo by-pass from major hospitals; but, instead after undergoing the new treatment, they are absolutely fine and are leading a normal life.

Doctor's details for your info are:

SAAOL HEART CENTER
B-1103, Solitaire Corporate,
Near Divya Bhaskar House,
S G Highway, Ahmedabad

Mob: 9712305556 ( WhatsApp )
Mob: 9714105556
Email : saaol.ahmedabad@gmail.com


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PostPosted: 02 Dec 2016 19:46 
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Dr Dharmabalan posted this note:

Enhanced External Counterpulsation Therapy (EECP) is a procedure performed on individuals with angina or heart failure or cardiomyopathy in order to diminish symptoms of ischemia, improve functional capacity and quality of life. In various studies, EECP has been shown to relieve angina and decrease the degree of ischemia in a cardiac stress test.

Method

While an individual is undergoing EECP, he/she has pneumatic cuffs on his or her legs and is connected to telemetrymonitors that monitor heart rate and rhythm. The most common type in use involves three cuffs placed on each leg (on the calves, the lower thighs, and the upper thighs (or buttock)). The cuffs are timed to inflate and deflate based on the individual's electrocardiogram. The cuffs should ideally inflate at the beginning of diastole and deflate at the beginning of systole. During the inflation portion of the cycle, the calf cuffs inflate first, then the lower thigh cuffs and finally the upper thigh cuffs. Inflation is controlled by a pressure monitor, and the cuffs are inflated to about 200 mmHg.

When timed correctly, this will decrease the afterload that the heart has to pump against, and increase the preload that fills the heart, increasing the cardiac output.

Physiological considerations

One theory is that ECP exposes the coronary circulation to increased shear stress, and that this results in the production of a cascade of growth factors that result in angiogenesis. Patients will see improvements in symptoms of chest pain, shortness of breath, chronic fatigue (tiredness) as well as a significant improvement in exercise tolerance (energy).

Indications and Contraindications

Indications
Angina patients who are not relieved by medicine
Patients who don’t want to have bypass surgery
Patients who are contraindicated for bypass or angioplasty due to comorbidities ....

Contraindications:

Recent myocardial infarction or coronary artery bypass graft or cardiac catheterisation, unstable angina; overt congestive heart failure ...

N.B. Intra aortic balloon pump (IABP) gives internal counterpulsation .


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PostPosted: 02 Dec 2016 21:04 
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Cleaveland Clinic in the USA states:

There are a large, increasing number of patients who have persistent anginal symptoms, who have exhausted the standard treatments for revascularization and remain severely restricted. Enhanced External Counterpulsation (EECP) may stimulate the openings or formation of collaterals (small branches of blood vessels) to create a natural bypass around narrowed or blocked arteries.

Who is a candidate for EECP?
. You may be a candidate if you:
. Have chronic stable angina
. Are not receiving adequate relief from angina by taking nitrates
. Do not qualify as a candidate for invasive procedures (bypass surgery, angioplasty, or stenting)

What happens during EECP treatment?
EECP is a non-invasive, outpatient therapy. During treatment:

. Patients lie down on a padded table in a treatment room
. Three electrodes are applied to the skin of the chest and connected to an electrocardiograph (ECG) machine.
. The ECG will display the heart’s rhythm during treatment. Blood pressure is also monitored.
. A set of cuffs is wrapped around the calves, thighs and buttocks. These cuffs attach to air hoses that connect to valves that inflate and deflate the cuffs.
. Patients experience a sensation of a strong "hug" moving upward from calves to thighs to buttocks during inflation followed by the rapid release of pressure on deflation. Inflation and deflation are electronically synchronized with the heartbeat and blood pressure using the ECG and blood pressure monitors.

How does EECP work?
The EECP treatment gently but firmly compresses the blood vessels in the lower limbs to increase blood flow to your heart. Each wave of pressure is electronically timed to the heartbeat, so that the increased blood flow is delivered to your heart at the precise moment it is relaxing. When the heart pumps again, pressure is released instantaneously. This lowers resistance in the blood vessels in the legs so that blood may be pumped more easily from your heart.

EECP may encourage blood vessels to open small channels that become extra branches. These channels or collaterals may eventually become "natural bypass" vessels to provide blood flow to heart muscle. This contributes to the relief of angina symptoms.

How often are patients treated?
Patients who are accepted for treatment must undergo 35 hours of EECP therapy. Treatment is administered 1-2 hours a day, five days a week, for 7 weeks.

Published studies conducted at numerous medical centers have demonstrated benefits for most patients including:
. Less need for anti-anginal medication
. Decrease in symptoms of angina
. Increased ability to do activities without onset of symptoms
. Ability to return to enjoyable activities

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