Please follow these EECP Second Opinion steps and submit the form to get your cardiac status report.
These two procedures are one of the most abused and risky in the medical field. They are done for heart patients under the threat of heart attack and death if not done immediately. A second opinion is necessary to understand the risk and the availability of other effective and safe alternative procedures.
Recommendations or opinions can differ from one cardiologist to another. If the recommendation is based on the substantial evidence published, it cannot change from one cardiologist to another. Many expert opinions given are possibly not based on evidence-based Medicine but rather biased false information.
Medical therapy is the first line of treatment for a patient with heart disease. Optimization of medical therapy is required to control the cardiac symptoms, improve the quality of life, arrest the progression of your blockages, and finally to prevent heart attack and death. The medication classes include blood vessel dilators, Cholesterol-lowering, Antiplatelets, blood pressure-lowering, reducing heart rate, water pills, etc. Incredibly, Medical management works by both increasing the blood flow to the heart, reducing the workload.
Angioplasty is performed to improve the blood flow to the heart muscle. This treatment is widely known as the procedure to fix the blood vessel blockages carrying blood to the heart muscle. A long tube is inserted through the leg (femoral artery) or the wrist (radial artery) and slowly advanced towards your chest and into the narrowed part of the heart blood vessels (coronary artery). Then a wire with a balloon positioned in the blocked segment of the artery. The balloon is then slowly inflated, compressing the plaque against the vessel wall, thereby opening the artery's blocked portion. A stent is placed in the opened artery to prevent the blockage from growing again.
Coronary Artery Bypass Surgery is a major surgical procedure done under general anesthesia to improve the heart blood flow. The surgeon takes a healthy saphenous vein from the leg or Internal Mammary artery from the chest cavity, or radial artery from the wrist during the procedure. These vessels are called grafts and were used to bypass the blocked coronary artery and restore the heart muscle's blood flow. The number of grafts used depends on how many arteries are blocked. Since it's a major surgical procedure, it takes 4-6 hrs to complete and need hospitalization for approximately a week and 12-14 weeks to recuperate.
These three management modalities, including medications, Interventional and surgical treatment, have their advantages and limitations. Often, patients may not be relieved entirely of their cardiac symptoms with medical management alone, even with optimization of all the drug combinations. When they do not respond to drug therapy, they may have to undergo a coronary angiogram (CAG).Then maybe advised for PTCA or CABG based on their coronary blockage severity. These invasive procedures have their own risk, including procedural and shortterm and longterm complications, and not all patients can be candidates.
The need for alternative treatment for bypass surgery and Angioplasty procedure which is neither drugs nor Invasive has yielded a Non-Surgical, outpatient treatment called Enhanced External Counter Pulsation ( EECP). All the other mode of treatments it is the safest and equally effective treatment option.
A coronary angiogram is a diagnostic procedure done by injecting the dye into your heart blood vessels. They see the blood vessel and the blockages through x-ray.
The need for a coronary angiogram and further treatment depends on your coronary artery disease status / cardiac status. The coronary Angiogram can show the narrowing of the vessels and how severe the narrowing is. The Angiogram, however, will not provide information on which narrowing will cause a heart attack. Also, Angiogram will not show how much blood flow reduction the narrowing has caused. Angiogram also has considerable risk, so you should not undergo the procedure if you do not plan for Angioplasty or bypass surgery. An angiogram is never indicated if your symptoms are well controlled with medications and conservative treatment like EECP.
Your current cardiac status is one of the crucial factors to determine which treatment strategy best suits you. In the cardiology community, this chest pain or Angina is classified into two categories stable Angina(Chest pain) and unstable Angina(Chest Pain).
• Stable Angina(Chest pain)
• Unstable Angina(Chest Pain)
1. What is a stable Angina?
Stable anginal patients usually experience discomfort or pain in the chest when they do some activi-ty, which they are not used to or while doing some routine works. The Sudden excruciating pain in the chest they experience while doing some activity will stop within minutes if that particular activi-ty is stopped. The pain sometimes may require certain drugs like nitrate to be kept under the tongue to relieve. This type of patient is called stable. So stable patients would be able to carry out the regular activity, and the pain will be of only some inconvenience, and they continue their routine activities.
2. What is an Unstable Angina?
Unstable angina patients have a completely different presentation of symptoms. The treatment ap-plicable to stable and unstable is entirely different. In unstable patients, the pain is very severe, and it will not be relieved with rest or cardiac medications. If this is not treated immediately, there is an imminent chance of getting a heart attack. Unstable angina patients need admission and should be carefully monitored to prevent further pro-gression, which can damage the cardiac muscle due to a lack of blood flow. Once the muscle is damaged, it is called a Heart attack. It may require an emergency coronary angi-ogram followed by a Bypass surgery or Angioplasty to rescue the heart muscle from further dam-age. Always remember here the surgical procedures are emergency, not elective.
What is stable Angina and Unstable Angina?
What is stable and unstable angina(Chest Pain)?
இயல்பான நெஞ்சு வலி (STABLE ANGINA)மற்றும் இயல்பற்ற நெஞ்சு வலி(UNSTABLE ANGINA) என்றால் என்ன?
இயல்பற்ற நெஞ்சு வலி (UNSTABLE ANGINA) உள்ள நோயாளிகள் EECP சிகிச்சை முறையை எடுத்துக்கொள்ள முடியுமா?
Current Status of Bypass Surgery and Angioplasty effectiveness in Chronic Stable Angina Patients.
Can unstable angina patients take vaso-meditech EECP treatment?
The first-line treatment for a stable patient is optimal medical therapy with cardiac risk factor management and lifestyle changes.
How long drugs for heart disease is given to you before advising any of the above three treatment options.
Stable patient's chest pain and shortness of breath symptoms.
Medical therapy is the first-line treatment for stable patients with narrowing in the coronary artery. The first-line treatment can reduce your chest pain and protect against plagues, which burst open and trigger clot formation. These suddenly formed blood clots can obstruct blood flow and causes a heart attack.
The treatment option recommended to you will benefit you depending on the cardiac status, whether you are stable or unstable.
1. Have you chosen treatment due to fear of death?
Patients should be cautious when cardiologist uses these words : "You need Bypass Surgery or Angioplasty immediately or at the earliest." "You will get a heart attack anytime." "Without surgery, you won't live longer." You are healthy now; if you are not willing for Surgery now, later it will be Risky. Very often, these were the words used to drive you towards very high-risk Surgery. Then, as a patient, you have the right to have these words of caution written as a recommendation in writing by your cardiologist. However, every cardiologist will hesitate to provide you in writing that Bypass and Angioplasty were provided to prevent heart attack and death. If they do, please ask them to fill the form provided below.
2. Are the Stent and Surgery is for Prevention?
Cardiologists trying to argue Angioplasty and Bypass Surgery in stable patients will decrease heart attack and death are irrational. The quest to prove this theory cannot be sustained anymore after recent ISCHEMIA (2019) trial results. Also, Cardiologists should not be foolish enough to harm the patients in the name of Prevention.
3.What should patients know?
As a patient, you should understand some essential things from your doctor if the treatment sug-gested to you is highly risky. Rather than being told that the surgical procedure is beneficial, you should know how beneficial it is and in which way. In reality, you may be forced to do a risky procedure for the benefit of just a reduction of pain or an increase in walking distance a few seconds more. Here a second opinion is not a convenience but a life-saving necessity when there is a lack of clarity.
Three questions patients should ask you before Surgery(3QB4 Surgery).
Non-surgical Heart Treatment.
Evidence Against Bypass surgery and Angioplasty(Stable Patients).
Stable Angina patients should have these answers known to them clearly. If you have any more questions or do not understand, you should take a second opinion and get an explanation from the doctor.
Reduce chest pain.
Prevent Heart attack and death.
Reduce chest pain.
Prevent Heart attack and death.
Advised EECP to prevent the need for CABG and Angioplasty.
Prevention of death and Heart attack achieved by medications and lifestyle changes.
EECP has a better chance of reducing heart attack and death than Bypass Surgery and PTCA.
How convinced are you that you are that a stable patient and can avoid Bypass Surgery and Angio-plasty and choose EECP treatment.
You can download the form below if you need a template to show to your doctor. Please ask your cardiologist / CTVS to fill the form and sign it as a recommendation.
Download the form: Our second opinion template.