Q. Can EECP be done in a patient with chest pain and leak in valve?

Answered by
Dr. Muhammad M. Hanif Md.
and medically reviewed by Dr. Divya Banu M
Published on Dec 06, 2019

Hello doctor,

My sister suffers from kidney failure and has been undergoing dialysis since two years now. She was diagnosed with a leak in valve when she was admitted a month ago with severe chest pains. One doctor suggests EECP treatment for her. I would like a second opinion, as some doctors also said that cannot work for her.

Dr. Muhammad M. Hanif Md.

Cardiology Critical Care Physician General Medicine Internal Medicine
#

Hello,

Welcome to icliniq.com.

I want to assure you that do not worry as everything is going to be fine soon. Thanks for uploading the detailed case history (attachment removed to protect patient identity). I have thoroughly gone through your case and can well understand your genuine concerns.


The Probable causes:

EECP is advised for patients who have chronic stable angina (long lasting chest pain) and is on the medications for the same for long time. When medications (like calcium channel blockers, diuretics, beta-blockers) does not work longer, we consider EECP for such patients of coronary artery blockage.


EECP causes counter-pressure in the coronary vessels and there is formation and opening of new and smaller blood vessels in the heart muscles to supply the areas of the heart whose original vessels are blocked due to disease. These collateral-vessels work as a natural bypass for the heart.


I do not think she will be a good candidate for the EECP as she has a different problems related to the heart. She has dilated chambers of the heart on the left side i.e. left atrium and left ventricle which is causing minor problems with the valves too on the left side but valves in large are working fine.

It should be first managed with medications and follow up. I preferably suggest going for a repeat angiography to see if that previous chest pain was due to the blocked heart vessels.

Investigations to be done:

Cardiac angiography, comprehensive metabolic panel.

Treatment plan:

Can be decided on angiography report and may need only medical treatment first. Sometimes in future she may need angioplasty.
Follow up is a must in her case.


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