New treatment to treat the disease angina

It's a pain in the chest 9 million Americans live with every day. Angina is treatable, but most of the time patients have to take medication for the rest of their lives to control it.

In the medical moment, how a simple therapy is now helping patients kick it for good.

Connie Crews has a very important job. She's a full time mom to dogs Casey and Marty. While working her part time job as a nurse she realized something wasn't right with her heart.

Connie Crews, being treated for microvascular angina, explains when she realized something was wrong, "I noticed what I thought was heart burn, with the burning."

It was microvascular angina, or MVA. An early form, of coronary heart disease that occurs when arteries narrow and the heart doesn't get enough oxygen rich blood.

Dr. Ken Kronhaus, Medical Director, Lake Cardiology, explains how people with it do not have many options, "The vessels are too tiny to put a stent in, the medications work much less than half the time."

To treat it, he's using a non-invasive treatment for heart patients recently cleared by the FDA, enhanced external counterpulsation or EECP.

Dr. Kronhaus explains how the treatment works, "It milks the blood in the arteries and veins in the legs and increases the blood flow to the heart."

For seven weeks, patients lie on this bed for 35 one hour sessions. Blood pressure cuffs inflated with air are wrapped around each leg. They contract and expand with each heart beat helping develop better circulation.

Dr. Kronhaus explains that there are no needles or cutting, "Without any needles, cutting or added medication."

According to the mayo clinic, it's been proven to work in 75 to 80 percent of patients with angina symptoms. Doctor Kronhaus says the therapy could one day replace life-long heart drugs,

Crews describes how much better she has felt after the treatment, "I continue to feel better, to have more stamina and just have a better sense of well-being."

Doctor Kronhaus says MVA is most commonly seen in women who are transitioning to menopause, but it can also affect men. The EECP treatment can cost up to $6,000, but it's usually covered by insurance.


REPORT: MB #3399

BACKGROUND: Angina pectoris is a Latin phrase that means "strangling in the chest". Patients often say that angina is like a squeezing, suffocating, or burning feeling in their chest, but an episode of angina is not a heart attack. The pain often happens after exercise. Unlike a heart attack, the muscle is not damaged forever, and usually goes away with rest. Angina is usually caused by coronary artery disease, CAD. The pain usually happens when a clogged or diseased vessel in the heart no longer delivers enough oxygen-rich blood to a part in the heart. Furthermore, Cardiac Syndrome X is related to microvascular angina. Cardiac Syndrome X is a condition where patients have the pain of angina, but they do not have CAD. Cardiac Syndrome X is more common in women, especially women who have gone through menopause. It is not life threatening and does not increase risk of CAD or heart attack. (

CAUSES: The causes of microvascular angina are not fully known. Some doctors think it has to do with how the patient feels pain, while others think it may be linked to low levels of the female hormone estrogen. In microvascular angina, the small blood vessels in the heart, capillaries, tighten or constrict. This tightening reduces the blood flow in the heart and causes the pain of angina. However, since the capillaries are so tiny, they do not increase the risk of heart attack. (

TREATMENT: EECP, Enhanced External Counterpulsation, is a non-invasive treatment that uses timed, sequential inflation of pressure cuffs on the calves, thighs and buttocks to augment diastolic pressure, decrease left ventricular after load, and increase deoxygenated blood return. Augmenting diastolic pressure displaces a volume of blood backward into the coronary arteries during diastole, a period of time the heart fills with blood, when the heart is in a state of relaxation and the resistance in the coronary arteries is at a minimum. The resulting increase in coronary artery perfusion pressure may enhance coronary collateral developmental or increase flow through existing collaterals, vessels. In addition, when the left ventricle contracts, it faces a reduced aortic pressure to work against since the counterpulsation has somewhat emptied the aorta. EECP has been primarily investigated as a treatment for chronic stable angina. (; American Medical Association)

APPLICATION: Intra-aortic balloon counterpulsation is a more familiar, invasive form of counterpulsation that is used as a method of temporary circulatory assistance for the ischemic heart, often after an acute myocardial infarction. In contrast, EECP is thought to provide a permanent effect on the heart by enhancing the development of coronary collateral development. A full course of therapy usually consists of 35 one-hour treatments, which may be offered once or twice daily, usually five days per week. The multiple components of the procedure include use of the device itself, finger
plethysmography to follow the blood flow, continuous electrocardiography to trigger inflation and deflation, and optimal use of pulse oximetry to measure oxygen saturation before and after treatment. (; American Medical Association)

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