by Stan Griffin, Deaf Friends International Special Contributor

Heart disease is one of the most deadly human ailments. Over 500,000 new cases are reported each year. Coronary diseases cause a large percentage of annual deaths in our country. It is undoubtedly the most expensive health care problem in the U.S., costing billions of dollars yearly.

Every day thousands of men and women visit their physicians complaining about chest pains or spasms, shortness of breath, fatigue, and extreme apprehension–all common symptoms of heart disease.

Treatment often involves invasive procedures such as; (1) by-pass operations in which leg veins are grafted to arteries so the new path goes around (bypasses) the blocked vessel; (2) angioplasty–a surgical repair of blood vessels; (3) grafting or laser revascularization

A new procedure is providing an alternate, non-evasive method of treatment for some cardiac patients. It is called "E. E. C. P." (Enhanced External Counterpulsation Therapy). It is most effective for: (1) patients having angina (Chronic Stable Angina Pectoris)–advanced coronary disease–the heart is saying it is not getting enough oxygen–over seven million Americans suffer from it; (2) patients who have had bypass surgery or angioplasty but symptoms have remained or returned; (3) patients who aren’t candidates for invasive surgery because of certain constraints or those don’t want to have it; and (4) patients with controlled congestive heart failure can be helped occasionally

To understand "E. E. C. P." you must first grasp the workings of a "cardiac cycle." This is the period from the beginning of one heartbeat to the beginning of the next. It includes "diastole" when the heart relaxes and fills with blood and "systole" when the heart contracts and pumps blood out of the body.

The purpose of "E. E. C. P." is to stimulate opening or formation of small branches of blood vessels (collaterals) to create a NATURAL pathway around narrowed or blocked arteries. Additionally it is hoped it will provide reduction or elimination of other heart disease symptoms. The name generally describes what will happen during treatment:

ENHANCED–Describes the equipment evolving through years of research to become state of the art

EXTERNAL–Means treatment happens outside the body and doesn’t require surgery.

COUNTERPULSATION–The system compresses the lower limbs to increase blood flow toward the heart. Each wave of pressure is electronically timed to the heartbeat so an increased blood flow is delivered to the heart at the precise moment it is relaxing (diastole).

When the heart pumps again, pressure is released instantaneously. This lowers resistance in the legs’ blood vessels so blood may be pumped more easily from the heart (systole), decreasing the amount of work required of the heart muscle.

During counterpulsation, the system pumps when your heart is resting and releases pressure when your heart is working.

"E. E. C. P." should NOT be used for patients with: 1) uncontrolled congestive heart failure; 2) severe vascular disease; 3) uncontrolled arrhythmia (variation from the normal rhythm of the heartbeat); 4) hemorrhage (bleeding); 5) coagulopathy ( defect in the blood clotting mechanism); and 6) thrombophlebitis (inflammation of a vein associated with a type of blood clot).

This treatment dates back to the 1950s. Researchers like Kantrowitzt, Harken, Birtwell and Clauss at Harvard, and Zheng and colleagues at Sun Yat Sen University in China are among the researchers who fine-tuned the process to its present respected position in the medical catalog.

This procedure is performed on an outpatient basis, usually in a doctor’s office and is supervised by medical professionals. No needles are used, and nothing invasive occurs. To get the most benefit, it’s recommended that hourly sessions take place for 35 consecutive days. The risk of causing harm to a patient is slight. It is safe and painless. Most health plans (including Medicare) fully cover it.

Over the years "E. E. C. P." has been shown to have an 80% success rate and produce a "significant improvement (in) or complete end to symptoms of heart disease." Most patients reduce or eliminate the use of nitroglycerine and other medications, and most "have major improvements in stamina, exercise tolerance, and overall quality of life." Those changes last for at least three years, and one study showed patients do as well five years after "E. E. C. P." as those who have surgery. There is also a substantial reduction in the " ... frequency and intensity of chest pains ..."

Here are the steps patients go through during a treatment:

(1) He or she lies on a special therapy bed.

(2) A series of cuffs (a larger version of those used for taking blood pressure) are wrapped around the legs at three points: A) calf level; B) upper thigh; and C) lower thigh.

(3) An EKG machine is hooked up to the cuffs so they will inflate and deflate in sync with the heartbeat

(4) During "distole"-- the heart’s resting phase–it receives a supply of blood–all three cuffs inflate, pushing oxygen-rich blood toward the heart. The pressure produces "counterpulsation," increasing the blood volume and pressure in the aorta.

(5) During "systole"–just before the heart begins to pump–cuffs deflate, and blood leaves the heart with less work for the muscle. It results in increased cardiac output with lower systolic pressure.

"E. E. C. P." is performed at over 300 locations in the United States, as well as in 13 other countries. Among those U. S. locations are: the Mayo Clinic, Johns Hopkins Medical Center, the University of Pittsburgh, and the University of Virginia.

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