"Squeezing" Away Chronic Chest Pain Medical News and Health Information
Squeezing" Away Chronic Chest Pain -- Research Summary
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. (http://www.texasheartinstitute.com/)
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. (http://www.texasheartinstitute.com/)
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. (http://www.ncdhhs.gov/; 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. (http://www.ncdhhs.gov/; American Medical Association) MORE
FOR MORE INFORMATION, PLEASE CONTACT:
Kenneth D. Kronhaus, MD
Cardiologist
kkronhaus@lakecardiology.com
http://www.drkenshow.com/
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