IS EECP CLINICALLY APPROVED & SAFE?

IS EECP CLINICALLY APPROVED & SAFE?

Yes, EECP is an US-FDA Approved Treatment for Chronic Stable Angina. Please check the following research studies which proves EECP is beneficial & a very safe treatment.

  1. MUST EECP TRIAL:

The multicenter study of enhanced external counterpulsation (MUST-EECP): effect of EECP on exercise-induced myocardial ischemia and anginal episodes

https://www.jacc.org/doi/full/10.1016/S0735-1097%2899%2900140-0

  1. PEECH EECP TRIAL:

Enhanced External Counterpulsation Improves Exercise Tolerance in Patients With Chronic Heart Failure.

https://www.sciencedirect.com/science/article/pii/S0735109706011296

  1. US – FDA Approval:

The Role of Enhanced External Counter Pulsation Therapy in Clinical Practice.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3917995/

  1. EECP – A FDA Approved Outpatient Therapy For Chronic Stable Angina

https://my.clevelandclinic.org/health/treatments/16949-enhanced-external-counterpulsation-eecp

  1. A.P.J. Abdul Kalam: Former President of India approves ECP:

http://abdulkalam.nic.in/sp031006.html

Benefits of Walking

Walking offers benefits with every step and it is one of the best exercise for good health of your heart, You need to walk atleast 30 minutes per day, It’s always possible to find sometime for your cardiovascular fitness in the form of walking.

1) You can go for early morning walk daily ,biggest advantage of the morning walk is you will get fresh air which will help to keep you energetic n fresh throughout the day.
2) Avoid Vehicle for walkable distance.
3) Take the stairs instead of the elevator.
4) Wear a pedometer to keep track of your physical activity.
5) Set a timer to get up & move after certain interval , specially those who do sedentary work .
6)walking can be combine with certain exercises like push,pull,lift,squat etc.
7)As you walk take larger steps than normal.
With little practice and patience you can start your way up to more expercise and the 30 minutes walk everyday will make a good starting point.If you want to improve the the heart health,don’t let the excuses stop you.
Walking is one of the most powerful ways to stay strong, maintain a healthy weight and live longer, health benifits of walking are endless and walking can improve your mental and physical Health.
Benifits of Regular walking –
1) Regular walking helps in maintaining healthy weight and lose body fat.
2) It helps to keep your cholesterol level ,Blood sugar level under control in Diabetic patients.
3) It also helps to control the blood pressure in Hypertensive patients.
4)walking improves cardiovascular fitness-walking ,especially speed walking is a great way to strengthen your heart and boosts blood circulation to all the organs in the body.
5)It improves respiratory function and lung capacity
6)It also strengthen your bones , muscles and immune system of the body.
7)Walking helps a lot in digesting the food properly
8)It’s helps in releasing away all the stress and tension at both mental and physical level.
Following the proper posture while walking is very important

-You should keep your head up ,look straight forward and not at the ground.

-Your shoulder, neck and back should be in relaxed position .
-You are swinging your arms freely with slight bend in your elbow.
How to start a walk
A good and correct way of walk should always start with
Warm Up – that means initially atleast for 10 minutes you should walk slowly and steadily.
Brisk walk – after warm up increase your speed Slowly without getting any stress on body.
Cool down – At the end of walk, again walk slow for 5-10 minutes, this will help in relaxing the muscles. Once you stop walking gently streach your muscles.
Walking is an important part of Cardiac rehabilitation Programs and for people diagnosed with heart disease or recovering from heart attack, but a cardiac patient should always speak to his doctor before starting any exercise or walk.

By-Dr Aarti

Diabetes and Heart

What is diabetes?

Diabetes mellitus is a disease that affects how our body uses blood sugar (glucose). Glucose is the important source of energy for the muscles and tissues in the body. It is also the primary source of energy for the brain.

In diabetes, blood sugar levels increase above the normal level. High blood sugar levels can lead to several serious health problems. The cause of high blood sugar depends on the types of the diabetes. There are mainly two types of chronic diabetes; Type 1diabetes and Type 2 diabetes.

 

In type 1 diabetes our body cannot produce enough insulin. Insulin is the hormone secreted by the beta cells of pancreas. Insulin helps blood glucose enter in to the cell of the body. In absence of insulin, blood sugar cannot enter in to the cells thus level of sugar in blood increases and cells are deprived of glucose.

 

In Type 2 diabetes, pancreas does produce the insulin but cells of the body become resistance to insulin due to various reasons. Due to insulin resistance cells cannot utilize the blood glucose effectively, leading to increase in blood sugar.

 

There are other types of diabetes also including pre diabetes and gestational diabetes. Prediabetes is the condition where blood glucose levels are higher than normal, but not high enough to be classified as diabetes. Prediabetes can progress in to type 2 diabetes unless proper lifestyle modification measures are taken.

 

Gestational diabetes occurs during pregnancy and often resolves after the birth of the baby. Person with gestational diabetes has the high risk of developing type 2 diabetes in future.

 

Diagnosis of prediabetes:

Prediabetes is diagnosed if fasting blood sugar is between 100 mg/dl to 125 mg/dl.

OGTT(oral glucose tolerance test) is blood sugar 2 hours after taking glucose orally, if it is between 140 mg/dl to 199 mg/dl, it is considered as prediabetes

HbA1c is the average blood sugar of past 3 months. HbA1c level between 5.7% and 6.4% is considered as prediabetes.

 

Diagnosis of diabetes: Diabetes is diagnosed is if fasting blood sugar is greater than or equal to 126 mg/dl or OGTT 2 hour after taking glucose if blood sugar is greater than or equal to 200 mg/dl

HbA1c more than 6.5% is considered as diabetes.

 

Symptoms of Diabetes:

Diabetes can remain symptomless in some patients and in some patients it can cause several symptoms like increased thirst, frequent urination, extreme hunger, weight loss, fatigue, blurred vision and slow healing wounds.

 

Complications of diabetes:

High blood sugar levels over several years causes damage to blood vessels and nerves which leads to several complications such as heart disease, stroke, nerve damage (neuropathy), kidney damage (nephropathy), eye damage (retinopathy), eye damage (retinopathy), foot damage etc.

 

Diabetes and Heart Disease:

The term “heart disease” includes several kinds of problems that affect the heart.

 

Coronary artery disease is the most common and fatal complication of diabetes. It is caused by the build-up of plaque in the walls of the arteries reducing the blood and oxygen supply to the heart muscles, this process is called atherosclerosis. Decreased blood flow to the heart can cause angina (chest pain) and it could also lead to a heart attack.

 

Diabetic Cardiomyopathy:

Other complication of diabetes is cardiomyopathy. In Diabetic cardiomyopathy, muscles of left ventricle (pumping chamber) of the heart become hypertrophic (enlarged) leading to poor contraction and relaxation of the left ventricle affecting the blood supply to whole body.

 

How to prevent and control diabetes and its complications?

Diabetes is known as lifestyle disease. With proper lifestyle modification we can prevent diabetes and its complications.  Lifestyle modification includes healthy diet, exercise, stress management and stopping of smoking and alcohol consumption.

 

 

Diet:

Diet plays a major role in controlling diabetes and its complications. Diet should be plant based and free from animal products.

Stop consumption of sugar and jaggery completely, you can use dates as sweetener.

 

Fruits and vegetables: Eat lots of fresh and seasonal fruits and vegetables.

Fruits and vegetables are excellent source of Vitamins, anti-oxidants and fibres.

Avoid too much of sugary fruits and avoid fruit juices.

 

Fats: Avoid consumption of saturated and trans-fats. Reduce consumption of oil and butter as much as possible. Avoid any kind of fried food. Eat nuts and seeds such as almonds and flax seeds for healthy omega 3 fatty acid.

 

Bakery: Avoid refined and processed foods; avoid white flour, bakery item such as bread, biscuits and cakes.

 

Plant proteins: Beans and pulses are the rich source of healthy protein. Eat sprouts at least 3 to 4 times a week.

 

Water: Drink plenty of water, at least 2 to 3 litters per day. If you have heart condition then drinks water as per your doctor’s advice. Completely stop drinking Aerated drinks and sugary drinks.

 

 

Exercise: Exercise plays a major role in sugar metabolism. Moderate intensity aerobic exercise for 30 mins daily for 5 days per week is recommended. Strength training exercise and practice of Yoga are also very helpful in diabetes. If you are a heart patient then consult your doctor before starting any form of exercise.

 

Smoking and Alcohol: Quit smoking and alcohol consumption as it leads to several complications.

 

Stress Management: Try to manage your stress levels, learn time management, cultivate some hobbies, spend quality time with your family and friends, spend time with nature and practice Yoga and meditation.

 

Above article is just for information and please consult your doctor before following any information or advice given in above article.

What is Coronary Artery Disease?

Coronary artery disease develops when the major blood vessels that supply your heart with blood, oxygen and nutrients (coronary arteries) become damaged or diseased. Because of presence of some irritative substance in blood, the (endothelium) innermost layer of blood vessels gets damaged and cholesterol (lipid – LDL) and sometimes calcium gets deposited (plaque) in your artery (mainly coronary artery) which causes inflammation in coronary artery.

When plaque builds up, it narrows your coronary arteries, decreasing blood flow to your heart. Eventually, the decreased blood flow may cause chest pain (angina), shortness of breath, or other coronary artery disease signs and symptoms. A complete blockage can cause a heart attack.

Coronary artery disease often develops over decades; you might not notice a problem until you have a significant blockage or a heart attack. But there’s plenty you can do to prevent and treat coronary artery disease. A healthy lifestyle can make a big impact.

 

Symptoms

If your coronary arteries gets narrow, they can’t supply enough oxygen-rich blood to your heart — especially when it’s beating hard, such as during exercise. At first, the decreased blood flow may not cause any symptoms. However, as plaque continues to build up in your coronary arteries, you may develop signs and symptoms, including:

Chest pain (angina): You may feel pressure or tightness in your chest, as if someone is crushing or as if someone has put some heavy weight on your chest. This pain, referred to as angina, usually occurs on the middle or left side of the chest. Angina is generally triggered by physical or emotional stress. The pain usually goes away within minutes after stopping the stressful activity. In some people, especially women, this pain may be felt in the neck, (left) arm or back.

Shortness of breath: If your heart can’t receive enough blood, it can’t pump out enough blood to meet your body’s needs. In such condition, you may develop shortness of breath or difficulty in breathing on exertion or extreme fatigue with exertion.

Heart attack: A completely blocked coronary artery will cause a heart attack. The classic signs and symptoms of a heart attack include crushing pressure in your chest and pain in your shoulder or arm, sometimes with shortness of breath and sweating. Sometimes a heart attack occurs without any apparent signs or symptoms.

Age: Simply getting older increases your risk of damaged and narrowed arteries.

Sex: Men are generally at greater risk of coronary artery disease. However, the risk for women increases after menopause.

Family history: A family history of heart disease is associated with a higher risk of coronary artery disease, especially if a close relative developed heart disease at an early age. (Your risk is highest if your father or a brother was diagnosed with heart disease before age 55 or if your mother or a sister developed it before age 65)

Smoking: People who smoke have a significantly increased risk of heart disease. Exposing others to your secondhand smoke also increases their risk of coronary artery disease.

Alcohol use: Heavy alcohol use can lead to heart muscle damage. It can also worsen other risk factors of coronary artery disease.

High blood pressure: Uncontrolled high blood pressure can result in hardening and thickening of your arteries, narrowing the channel through which blood can flow. High blood cholesterol levels. High levels of cholesterol in your blood can increase the risk of formation of plaque (atherosclerosis). High cholesterol can be caused by a high level of low-density lipoprotein (LDL) cholesterol, known as the bad cholesterol. A low level of high-density lipoprotein (HDL) cholesterol, known as the good cholesterol, can also contribute to the development of atherosclerosis.

Diabetes: Diabetes is associated with an increased risk of coronary artery disease. Type 2 diabetes and coronary artery disease share similar risk factors, such as obesity and high blood pressure. Overweight or obesity. Excess weight (especially around waist) typically worsens other risk factors.

Physical inactivity: Lack of exercise also is associated with coronary artery disease and some of its risk factors, as well. High stress. Unrelieved stress in your life may damage your arteries as well as worsen other risk factors for coronary artery disease.

Unhealthy diet: Eating too much fatty food, salt and sugar can increase your risk of coronary artery disease.

 

EECP Treatment for Coronary Artery Disease.

Enhanced external counterpulsation (EECP) is a mechanical form of treatment for angina. While several clinical studies appear to show that this treatment can be helpful in reducing symptoms of angina in patients withcoronary artery disease (CAD). EECP was approved by the US Food and Drug Administration in 1995 for the treatment of coronary artery disease (CAD).

Several studies suggest that EECP can be quite effective in treating ischemic heart disease. EECP significantly improved both the symptoms of angina (a subjective measurement) and exercise tolerance (a more objective measurement) in patients with CAD. EECP also significantly improved “quality of life” measures, as compared to placebo therapy.

Food and Fruits that Benefit Heart

A healthy diet helps in keeping us fit and away from metabolic disorders. In fact, certain foods can influence blood pressure, triglycerides, cholesterol levels and inflammation, all of which are risk factors for heart disease.

 

Here are certain foods the help in keeping the heart healthy:

  1. Green vegetables Consumption of at least one cup of green leafy vegetables can significantly reduce their risk of cardiovascular diseases.
  2. Broccoli and asparagus are filled with mighty nutrients such as vitamins C and E, potassium, folate, calcium and fiber.
  3. Almonds lowers your LDL cholesterol, or bad cholesterol, which is involved in creating plaques in your coronary arteries that can cause heart attacks.
  4. Walnuts are the only ones with a significant amount of a certain type called alpha-linoleic acid. Alpha-linoleic acid acts as an anti-inflammatory agent and has actually been shown to help reduce plaque buildup in coronary arteries
  5. Fruits such as oranges, cantaloupes and papaya are rich in beta-carotene, potassium, magnesium and fiber.
  6. Dried beans and lentils ― such as garbanzo, pinto, kidney or black beans, are high in fiber, B-vitamins, minerals
  7. Flaxseeds contain omega-3 fatty acids, fiber and phytoestrogen to boost heart health.
  8. Berries are full of heart-healthy phytonutrients and soluble fiber.
  9. Oats They’re a gluten-free whole grain and a great source of important vitamins, minerals, fiber and antioxidants
  10. Bell peppers: Bell peppers contain folate, another nutrient that reduces homocysteine.

What is EECP treatment?

For those who have heart disease and have been advised Bypass surgery or Angioplasty, there is an alternative treatment available. EECP (Enhanced external counter pulsation) treatment is a non-surgical treatment for coronary artery disease.

For those patients, who are not willing for surgery or not fit for surgery, EECP is an excellent option. EECP (Enhanced external counter pulsation) has been approved by the United States Food and Drug Administration (FDA) for management of angina (chest pain) and Hear failure.

EECP treatment is totally safe, painless and doesn’t require hospitalization.  In EECP treatment 3 sets of cuffs are tied at calf, thigh and hip region, these cuffs are inflated during every Diastole (relaxing phase of heart) and deflated just prior to Systole (Heart contraction).The  Inflation and deflation are electronically synchronized with the heartbeat. This treatment is given 1 hour daily for 35 sessions.

 

Hoe does EECP works?

With inflation of cuffs, blood is pushed back in to the heart arteries with force and volume and it helps in creating network of small arteries (Collateral circulation) thus creating “Natural Bypass” and increasing the blood supply to the heart muscles and relieving the chest pain. The cuff deflates just prior to the contraction of the heart so heart can pump the blood with more ease thus reducing pressure from heart.

 

Benefits of EECP

No need of surgery or any other painful treatment.

No hospitalization, no recovery time needed, patients can continue their normal activities.

EECP increases the blood and oxygen supply to heart muscles and reduces chest pain / discomfort.

EECP improves exercise tolerance and quality of the life.

Frequently Asked Questions On EECP

DOES THE BLOCKAGES GO AFTER TAKING EECP?

 

 One of the most asked questions about EECP treatment is does the blockage go after the taking the EECP treatment? No, the blockage that is there in the major arteries of the heart doesn’t go after the EECP treatment.

 

WHAT IS THE BENEFIT OF TAKING THE EECP TREATMENT?

 

The next question that arises in the patient mind is that when the blockage doesn’t go with EECP treatment then what is the benefit of this treatment.

The one thing that patient needs to understand that EECP treatment acts on the micro circulation of the heart. EECP helps in creating collateral circulation within the heart which helps in supplying blood to the area of the heart which was receiving less blood due to blockages in the major arteries.

Even when the patient undergoes a bypass surgery the objective of the surgery is to provide blood supply to the area of the heart affected by the blockage. So what the surgeon will do is take a blood vessel from a distal part of your body and create a diversion for blood to flow around the blocked vessel. So even after undergoing the knife in a major surgery cabg the blockage doesn’t disappear.

 

HOW MANY DAYS DOES THE EFFECT OF EECP LAST?

 

The benefit of EECP treatment last from 3 to 5 years but this benefit will vary from patient to patient. Some patients may require repeat 10-15 sessions every one or two years.

 

DOES EECP HELP IN HEART FAILURE PATIENTS?

 

Yes EECP does benefits heart failure patients. In some cases the ejection fraction also increases of the patient but this increase is also from patient to patient.

 

WHAT IS THE DURATION OF THE EECP THERAPY?

 

EECP treatment is a 35 days duration treatment in which patient has to come daily for one hour of EECP session. Some patients may require extra 5-10 sessions as per improvement noted in the patient.

 

Benefits of EECP – EECP Heart Therapy

EECP is a safe, non-invasive, well tolerated and effective for patients with ischemic heart disease, angina and heart failure.

1) EECP feels like a deep muscle massage for the legs. During treatment, you do not feel anything in the chest or heart. Just it feels cuffs tires that wrap around your legs squeezing in time for your own heartbeat. Most of our patients relax, listen to music or watch TV during their treatments. Some even sleep!
2)  No side effects. However, some patients may experience muscle pain and fatigue in the first two weeks of treatment. This is similar to an exercise program. Special pants and fillers are used to minimize skin irritation by friction of the sleeve.

3) Most patients begin to feel better after 10 treatments.

4)  EECP therapy increases the blood supply to the heart and all the organs, tissues and cells of the body.

5) EECP therapy reduces symptoms of chest discomfort and / or difficulty breathing; and the amount of drugs taken by the patient.

6) EECP therapy improves exercise capacity and quality of life.

7)  The benefits of EECP therapy can last several years. Some patients require repeat therapy as recommended by the cardiologist.

 

Patient who will benefit from EECP:

Patients whom PTCA or CABG is not Contemplated.

  1.  Target Lesion is Inaccessible.
  2.  Patients have Co-morbid states like diabetes, nenal dysfunction and
  3.  pulmonary disease which create high risk.
  4. Severe LV dysfunction – High risk CABG.
  5. Restenosis after PTCA.
  6.  CABG graft occlusion.

 

What percent of heart blockage is dangerous?

Severe heart blockage is typically that in the greater than 70% range. This degree of narrowing is associated with significantly reduced blood flow to the heart muscle and can underlie symptoms such as chest pain and shortness of breath. In the diagram above, an 80% blockage can be seen at the beginning of the vessel.

Diagnostic Test Done For Heart Functioning And Their Significance

Heart disease patients or those suspected of having a heart disease are advised a number of test to determine the functioning of heart in various parameters. Various diagnostic test like ECG, Holter monitoring, Stress test and Echocardiogram have different significance when he comes to determine the heart functioning.

 

 

 

ELECTROCARDIOGRAM

     ELECTROCARDIOGRAM measures the electrical activity of the heart. ECG is the first line of diagnostic test to be done when patient has severe angina (chest pain) at rest or heaviness feeling in the chest.

ECG helps in following ways

1) First line of test to determine if patient is having a heart attack.

2) It helps to monitor changes in heart rhythm

3) helps to predict if heart attack is developing.

 

ECHOCARDIOGRAM

In echocardiogram sound waves are used to see how your heart is beating and also to see how your blood is moving through the heart chambers.

It basically helps us to determine the following

1) The heart pumping percentage i.e. how much percentage of volume the heart is pumping at each systole

2) Determine the cause of heart murmur

3) Helps in assessing functioning of heart valves

4) Helps in assessing the heart chamber size and functioning

 

TREADMILL STRESS TEST

In this test the patient is made to walk on a treadmill while ECG is being recorded while the patient walks on the treadmill.

Treadmill stress test help is assessing following things

Determine the cause of chest pain, shortness of breath and weakness

1) Assess the health of the heart

2) Assess safety of exercise

3) Identify heart rhythm changes with activity

4) Find evidence of inadequate blood flow to the heart muscle during exercise

 

HOLTER MONITORING

The cardiologist may request a Holter monitor ECG if you have symptoms, such as dizziness, fainting, low blood pressure, ongoing fatigue (tiredness), and palpitations and a resting ECG doesn’t show a clear cause. The Holter monitor is a type of portable electrocardiogram (ECG). It records the electrical activity of the heart continuously over 24 hours or longer while you are away from the doctor’s office. Following assessment can be made from holter test

1) To evaluate chest pain that can’t be reproduced with exercise testing

2) To evaluate other signs and symptoms that may be heart-related, such as tiredness, shortness of breath, dizziness, or fainting

3) To identify irregular heartbeats or palpitations

4) To assess risk for future heart-related events in certain conditions, such as hypertrophic cardiomyopathy (thickened heart walls), after a heart attack that caused weakness of the left side of the heart, or Wolff-Parkinson-White syndrome (where an abnormal electrical conduction pathway exists within the heart)

5) To see how well a pacemaker is working

6) To determine how well treatment for complex arrhythmias is working

DIAGNOSIS AND PREVENTION OF HEART ATTACK

PREVENTION OF HEART ATTACK

Heart Attack is the leading cause of death worldwide. In India people about 25-30% dies due to heart attack. Heart is supplied by three major blood vessels, RCA, LAD & LCX. When one of the blood vessels get 100% blocked due to thrombus the area supplied by the vessel starts to die. During this the patient experiences severe chest pain, breathlessness and heaviness in chest.

Heart attack happens when the lining of the plaque in the blood vessel rupture and causes thrombus formation. The percentage of heart blockage doesn’t determine when the plaque will rupture. A blood vessel having 60% blockage can also rupture and cause heart attack.

Patient having heart blockage has symptoms of chest pain and heaviness and subsides when he takes rest or takes Tab sorbitrate. When heart attack takes place chest pain is usually at rest and doesn’t get relieved by taking tab sorbitrate. Another presentation of heart attack could be burning in epigastric falsely diagnosed as gastric problem. If you have any one of the following symptoms, one should get an ECG and Trop T done to ascertain whether the chest pain is of heart attack or no.

Prevention of Heart Attack:

Once the blockage has been detected, treatment should be done for the heart blockage. If the person doesn’t know whether he has blockage or no ascertain whether his risk factors for heart disease like high cholesterol level, smoking, diabetes, obesity or family history of heart disease. He should undergo a CT coronary angiography and ascertain how much blockage he has in the heart. Patient should modify the risk factor like quit smoking, reducing weight keeping blood pressure cholesterol levels diabetes in check.  For treatment of heart blockages we at CORDIS HEART INSTITUTE provide EECP treatment which is a non-invasive treatment which helps in increasing the blood supply to the deficient areas of the heart through collateral circulation.