Patient's Query
Hello doctor,
My father is 51 years old and has a normal weight (he is fit), but he has diabetes and now a heart condition. He recently had an angina attack. The doctors say that bypass surgery or angioplasty are the options since three of his heart valves are 70 to 80 percent blocked. He is on a strict diet with no oil at all, only salad. We recently heard about an option called EECP (enhanced external counterpulsation), so we were thinking of trying that instead of surgery, as we are scared and not mentally prepared for it yet. My question is: Is EECP a good option? My father has been feeling fine for the past three to four days.
Please advise.
Hi,
Welcome to icliniq.com.
Science is based on evidence and experimentation. As for three-vessel disease and diabetes mellitus, the evidence favors CABG (coronary artery bypass graft) if there are suitable targets (meaning vessels that can be bypassed). Many trials support this decision. Another option is PCI (percutaneous coronary intervention). So, when talking about the treatment of choice in your case, it is CABG. If CABG is not possible, feasible, or desired, the next option is always PCI.
Regarding EECP (enhanced external counterpulsation), it is usually reserved for patients who are not candidates for CABG or PCI, who are on maximum medical treatment, and who still experience chest pain. In such cases, EECP can be an option. EECP is never the first choice for patients who are candidates for CABG or PCI. However, medical ethics dictate that we must always respect the patient's choice. If the patient does not want to undergo an invasive procedure, then non-invasive treatments like EECP and medical management can be considered as primary options.
There is no doubt that EECP is also effective in treating anginal pain. EECP works by creating turbulence in the blood within the coronary vessels, speeding up the formation of new blood vessels in the heart, but it does not open already blocked vessels. In my opinion, I would prioritize CABG first, PCI second, and EECP third. But if the patient and their family prefer EECP, I would respect their decision.
I hope this helps you.
Thank you.
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Answered byDr. Muhammad Zohaib Siddiq
Medically reviewed byDr. K. Shobana
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