Frequently asked questions

 

What is angina?

Angina literally means “strangling in the chest”. It is the most common form of coronary artery disease, which occurs when vessels that carry blood to the heart muscle become narrowed and blocked by deposits of calcified fatty tissue (plaque).

Is angina life threatening?

Angina signals heart disease, the number one killer in the industrialized world. Two to four percent of people with angina die from heart disease. More than 7 million people in the United States suffer with angina. An estimated 350,000 new cases occur each year. Of this number, approximately 1 million will have invasive procedures; 6 million patients who are maintained on drug therapy live in varying degrees on discomfort. Angina is frequently crippling and disabling;, patients are often unable to maintain their lifestyles.

What does it feel like?

The majority of patients with angina complain of chest discomfort provoked by mental, physical, or emotional stress. Discomfort can vary widely among patients who report shortness of breath, fatigue, indigestion, faintness, jaw pain, and other symptoms. Angina can also feel like a pressing or squeezing
pain, usually in the chest under the breast bone, and sometimes in the shoulders, arms, neck, jaws, or back.

What triggers angina?

Angina occurs when the heart needs more oxygen from the blood. Physical activity often triggers angina. Other triggers include emotional stress, extreme cold or heat, heavy meals, alcohol, and cigarette smoking.

How does angina affect people?

Angina restricts the activities of many patients. They are able to walk, but not uphill or carrying packages. For some patients, angina is disabling, interfering with their ability to work or engage in various activities.

How is angina avoided?

Doctors recommend controlling the risk factors that contribute to underlying coronary artery disease. These risk factors include high blood pressure, cigarette smoking, high blood cholesterol levels, and obesity.

What is the first line of treatment for angina?

Angina is usually controlled by medication that helps increase the supply of oxygen to the oxygen-deprived heart muscle by dilating coronary vessels or decreasing the demand for oxygen. Unfortunately, in most patients, medication becomes less effective over time.

When should ECP treatment be used for angina?

ECP treatment may be used to treat any patient with chronic unstable angina, but it is usually reserved for patients taking medication that is losing its effectiveness.

What is ECP treatment?

The ECP procedure is a noninvasive outpatient treatment that is used to relieve or eliminate angina. It is believed to create new pathways around blocked arteries in the heart by expanding networks of tiny blood vessels that help increase blood flow to the heart muscle.

What are the advantages of ECP treatment?

Unlike procedures such as bypass surgery and balloon angioplasty, ECP® treatment can be administered can be administered in outpatient sessions, carries little to no risk, and is relatively comfortable.

Will ECP treatment eliminate the need for bypass surgery?

No. Some patients with more extensive disease or those who have disease of the left main coronary artery require bypass surgery. ECP treatment is an option for patients who are unsuitable for or unwilling to undergo, invasive procedures. For patients who have undergone multiple invasive procedures and for whom additional surgery carries excessive risk, ECP treatment may be the only way to obtain relief from crippling angina.

What are the clinical benefits of treatment?

ECP treatment can reduce or eliminate the frequency and intensity of chest pain, decrease the need of medication, and greatly improve the ability to participate in activities of daily living. After receiving ECP treatment, patients often are able to enjoy moderate exercise for the first time since developing angina.

Are there any downsides to the procedure?

The length of treatment may be a consideration to some people. It can take between four to seven weeks to complete a course of ECP treatment. During that time, patients must visit an outpatient clinic and receive treatment for one or two hours per day. Some patients with more extensive disease may require more than one course of therapy to achieve optimal relief.

What have studies shown about ECP and its effect on angina?

In 1989, the Health Sciences Center, State University of New York at Stony Brook, began clinical studies with ECP treatment for patients with chronic angina. These studies demonstrated a number of positive effects that are maintained after treatment for at least three years after completing a full course of ECP treatment.

How is ECP treatment performed?

During treatment, patients lie on a padded table in which sets of electronically-controlled inflation valves are located. These valves are connected to specially designated adjustable cuffs that are wrapped firmly, but comfortably, around the patient’s calves, lower thighs, and upper thighs, including the buttocks. While
the heart is in its resting phase, the cuffs are inflated sequentially and rapidly from the calves toward the buttocks. The cuffs are then deflated instantaneously just before the heart beats. This causes the heart muscle to receive an increased blood supply while reducing the heart’s work load.

How does ECP treatment work?

The body has its own solution to an inadequate blood supply caused by blocked or partially blocked arteries. When an artery is severely narrowed, the body can increase the the amount of blood flowing to the heart muscle by opening up small branches of nearby arteries. Known as collateral circulation, these networks of blood vessels create new routes for blood to detour around clogged arteries.The development of a collateral circulation is particularly important in the heart muscle where it may be life saving. However, the development of collateral circulation is a gradual process, and not everyone has the same ability to develop these networks.

Where else is ECP performed?

ECP is performed at more than 500 locations throughout the U.S., as well as around the world, including: Argentina, Canada, Columbia, France, Germany, India,Ireland, Israel, Italy, Japan, Saudia Arabia, Turkey, and the United Kingdom.