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Published on Feb 28, 2019
Heart failure doesn’t mean the heart is completely stopped functioning it only means the heart is not adequately pumping the blood to the requirement for the metabolic need of the body. So what are the symptoms of heart failure? Usually patients with heart failure, they cannot carry any work because of the breathing problem. We call this symptom as shortness of breath. They walk 2-3 minutes and they complain of shortness of breath, they cannot lie down and sleep properly because of the shortness of breath or a severe cough and sometimes this patients even cannot eat anything, even a small quantity of food they will complain of abdominal distension and they leave a very poor quality and they cannot take part in any active lifestyle.
So what are all the treatment options available for heart failure patients? Because of heart function is significantly reduced the patient cannot be provided with any interventional treatment options like bypass surgery and angioplasty. Even if they are provided as an option, they carry a very high risk. So most of the times these patients refuse to undergo an interventional procedure or the interventional cardiologist or cardiothoracic surgeons may deny taking them for a bypass or angioplasty due to high risk.
Then what are the other treatment options available for them? ) They can be on medical management, but because of medical management is already maximum, they cannot increase the medical management further. (2)They can be given what we call as a cardiac defibrillator or resynchronization therapy or ventricular assist device or heart transplant. All these options are expensive and only a few can able to afford this expensive device-based management for heart failure. Now, how EECP can help these groups of patients? EECP can able to help by improving the blood circulation into the myocardium by compressing the lower legs. Once the blood supply to heart muscle is increased the blockage can be detour by the formation of the new blood vessels across the blocked artery. So this can able to strengthen the heart muscle. Many clinical papers have shown, once these heart muscles are strengthened it can able to pump much better than before. So the overall pumping function of the heart will significantly improve. Once the pumping function can be improved, these patients quality of life can be also improved and they can able to walk more distance than before. So EECP would be the best option for these type of patients who we call them as heart failure.
Now the heart failure prevalence is significantly increased across our country and many hospitals are starting what we call as heart failure clinic. The reason is life expectancy has increased. A couple of years before the life expectancy is only around 65, now it comes around 70. Elderly you are more chance to get heart failure. In patients who had a heart attack previously a couple of decades ago, when they are taken into hospitals for myocardial infarction or heart attack, the mortality rate is very high around 60-80% but now after the introduction of interventional procedures and medical management, these patients walk out of the hospital with less than 3% of mortality. Now we have these people who already had a damaged heart. So in the future, they have a higher chance of going for heart failure. Another problem is the poor management of coronary artery disease. Many patients even after undergoing a successful bypass surgery or angioplasty would not follow the drug regimen or would not control the blood pressure, hypertension or cholesterol level. So eventually they develop a heart attack and end up having heart failure. So for all these conditions, EECP would be a very safe alternative and effective and also no risk is involved and can significantly improve the patient's overall condition.