Is EECP feasible for a person with a valve leak?

Question

Hello doctor,

My sister suffers from kidney failure and has been undergoing dialysis for the past two years. She was diagnosed with a valve leak when she was admitted a month ago with severe chest pains. One doctor has suggested EECP (enhanced external counter pulsation) treatment for her, but I would like a second opinion, as some doctors have said it may not work for her.

Answer 1

Hello,

Welcome to icliniq.com.

I want to assure you not to worry, as everything will be fine soon. Thank you for uploading the detailed case history (attachment removed to protect patient identity). I have thoroughly reviewed your case and completely understand your genuine concerns.

Enhanced external counter pulsation (EECP) is advised for patients with chronic stable angina (long-lasting chest pain) who have been on medications for a long time. When medications (such as calcium channel blockers, diuretics, and beta-blockers) no longer work, we consider EECP for patients with coronary artery blockage. EECP creates counter-pressure in the coronary vessels, leading to the formation and opening of new, smaller blood vessels in the heart muscle, which supply areas of the heart whose original vessels are blocked due to disease. These collateral vessels act as a natural bypass for the heart. I do not think she will be a good candidate for EECP, as she has other heart-related issues. She has dilated chambers on the left side of the heart, specifically the left atrium and left ventricle, which are causing minor problems with the valves on the left side, although the valves are generally functioning well. This should first be managed with medications and follow-up care. I would preferably suggest a repeat angiography to determine if the previous chest pain was caused by blocked heart vessels.

I hope this helps you.