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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.

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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.
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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.

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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.

 

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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.