Frequently Asked Questions
1. What are the basic tests for early diagnosis of CAD
The basic tests we recommend are – Total cholesterol, Lipid profile, Tread Mill Test (Stress Test), 2D Echo, SphygmoCor. Depending on the risk factors and the condition of the patient a Preventive Cardiologist recommends relevant tests after consultation.
2. What are the basic tests for early diagnosis of CAD
We recommend you for a Calcium scoring through CT Scan. If your calcium scoring is higher than you have a higher chance of having calcified plaques.
You can also do a non-invasive CT Angiography which will show you the blockages developing throughout your arteries. CT angiography is 80-85% accurate test and if anybody undergoes this test, regular invasive angiography is not required. However if the pumping efficiency of the heart is low and patient has symptoms of chest pain not relieved by medications a coronary angiography can be advised.
In some patients blood flow/supply to heart muscles is studied by doing perfusion scans for heart e.g. Stress Thallium. It also determines the viability of the heart muscles after attack.
One can also do the study of Homocystine & Lipoprotein – A, because if this are above normal, there is possibility of having blockages or developing blockages in the future.
3. Why Blood flow study is important?
Blood flow study is important because 70% to 100% blockages either in single vessel or triple vessel does not mean that heart is receiving only 0 – 30% of blood. Heart muscles requires oxygen to pump effectively and the oxygen is carried by the blood to the muscles.
All the invasive and non-invasive treatments are done to improve the blood flow to the heart. Thus its essential to do the blood flow study by Stress Thallium as this will help to understand the need of the treatment.
4.What are the physical symptoms of CAD?
The usual symptoms are :
1. Chest pain on the left side, radiating towards your arm or neck.
2.Choking sensation in the chest
3.Pain in the lower jaw
4.Pain in the chest increases while walking reduces on rest.
5.Extreme fatigue without physical activity.
6.Breathlessness on exertion.
5.However in certain cases there are unusal symptoms like
1.Choking sensation in the throat
2.Pain in the upper back which increases on walking.
3.Pain in the chest while walking after eating food.
4.Burning sensation in the chest after meals.
5.A band like constriction feeling in abdomen while walking with increased speed
6.Does my heart get damaged during heart attack?
YES, when one gets a heart attack blood supply is completely cutoff to a certain portion of heart. If the blood supply – oxygen supply is not restored to that part of the heart within the first 60-90 mins then the muscles of the heart dies due to lack of oxygen. This creates the permanent scar . The scarred part of the heart will always remain dead and the heart has to compensate the blood supply to the body through the rest of the heart, which is alive. The degree of scarring cannot be predicted during an heart attack but by restoring the blood supply at the earliest the damage to the heart can be prevented or vastly reduced.
7.What are chances of a patient diagnosed Coronary Artery Disease having a Heart Attack:
A person diagnosed with CAD does not necessary mean that he is going to suffer from heart attack soon. Heart attack is a situation as explained earlier where blood supply to a certain part of the heart is completely cut off. Thus a person following a correct reversal program, where blockages are kept under control and slowly reversed, and improving the blood flow supply to the heart, avoiding mental stress, and having the right medication, one can easily avoid a Heart Attack in 95% of the situation.
8.When a bypass or angioplasty is recommended?
At IPC we give honest medical opinion, depending on the physical condition of the patient various diagnostic test reports and angiography we do patient selection for our non-surgical treatment. However in certain critical cases if bypass or angioplasty is essential we definitely give patients our opinion for the same. However as per our practice in last ten years with over 15000 consultations 90% of the patients can be treated without surgeries.
9.What is non-invasive cardiology?
Non invasive cardiology focuses at improving the blood supply to the heart without any form of invasive surgeries, catheters etc. and altering the blood chemistry – the reason which is developing the blockages
The treatments normally used in non-invasive cardiology are
1.EECP : (Enhance External Counter Pulsation”)
2.Cardiac Rehabilitation Program
10.Why EECP is called Natural Bypass?
Natural bypass is a process of creating and opening of millions of small arteries in the heart / capillaries through which blood flow takes place especially when major arteries are having blockages. EECP develops new pathways around blocked arteries in the heart by expanding networks of tiny blood vessels (“collaterals”) that help increase and normalize blood flow to the heart muscle. For this reason, it is often called the natural bypass.
11.What are the advantages of EECP?
Unlike bypass surgery, balloon angioplasty, and stenting procedures, EECP is non-invasive, carries no risk, is comfortable, and is administered in outpatient sessions.
EECP increases blood flow:
1.To heart by 20-42%
2.To brain by 22-26%
3.To kidneys by 19%
12.How does EECP affect the heart's output?
EECP increases heart’s output (stroke volume) by 12% by reducing after load. This improves LVEF.
13.Are there any risks or side effects of EECP?
EECP is safe. Occasionally, some patients experience mild skin irritation under the areas of the blood pressure cuffs. Experienced EECP therapists address this irritation by using extra padding where needed to make the patient comfortable. Some patients experience a bit more fatigue at the beginning of their course of treatment, but it usually subsides after the first few sessions. In fact, patients typically feel energized by EECP.
14.When can I expect to start feeling better from EECP?
Most patients begin to experience beneficial results from EECP between their 15th and 25th treatments. These benefits include increased stamina, improved sleeping patterns, decreased angina, and less reliance on nitroglycerin and other medications. There is variation, certainly, and some patients start to feel better as soon as their first week of treatment!.
15.What does EECP feel like?
EECP feels like a deep muscle massage to your legs. During the treatment, you do not feel anything in the chest or heart. You only feel the cuffs that are wrapped around your legs squeezing in time to your own heartbeat. Our patients have affectionately described this sensation as “gentle hugs.” Most of our patients relax, listen to music, or read during their treatments. Some even sleep!.
16.Do the benefits of EECP last?
Yes. In patients followed for three to five years after treatment, the benefits of EECP, including less angina, less nitroglycerin usage, and improved blood flow patterns documented on stress tests, had lasted.
17.Is there an age limit for EECP?
No. We have successfully treated patients as young as 36 and as old as 97 without any difficulties. Many of our patients are in their 80s and 90s and complete the entire EECP program with excellent results.
18.I have already had bypass surgery/angioplasty/stents. Can I still have EECP?
Yes! Most of our patients have already had one (or many) of these procedures. They come for EECP treatment because they still have angina.
19.Can EECP dislodge plaque and cause a stroke or heart attack?
No. Our bodies obey the laws of physics, and one principle law is that fluid will follow the path of least resistance. Atherosclerotic plaques are calcified and hard, and they create an obstruction that detours the blood through alternate routes. During EECP, when your blood is flowing to your heart, it will naturally bypass arteries with plaque and enter healthy, non-diseased blood vessels to go around the blockages. Going around the blockages is a longer trip, but it is a much easier one. In time, these new pathways are reinforced and become lasting routes for blood to reach your heart beyond the blockages. Every EECP patient has had multiple, serious blockages. No one has ever had a heart attack or a stroke as a result of the treatment.
20.Does EECP aggravate high blood pressure (hypertension)?
No. If you have hypertension that is properly managed, you may undergo EECP without difficulty. Oftentimes, patients with hypertension find that their blood pressure improves as they proceed with EECP. If your hypertension is uncontrolled, you must seek medical care to get your blood pressure under control with proper medications before proceeding with EECP.
21.What happens if my angina returns after I finish my EECP treatment course? Can I come back for more?
Yes. EECP is not a once-in-a-lifetime treatment. Heart disease is a chronic illness and symptoms may return at some point in the future.
22.Will EECP treatment will remove my blockages?
The EECP treatment does not remove any blockages you have, per se, but rather grows new collateral vessels around them. In that way EECP creates these “natural bypasses.” So instead of taking a vessel out of your leg, cutting your chest open and grafting this vessel onto your heart, EECP allows your heart to grow new vessels naturally, and non-invasively. That said, however, new studies are beginning to look at all the benefits of EECP in increasing the circulation everywhere in the body, not just in the heart. Blockages reverses when you, start on a healthy diet and exercise regimen, and change some of the lifestyle patterns that clogged up those arteries in the first place.
At the IPC HEART CARE CENTRE our treatments are augmented by an entire health information and lifestyle assessment package. Our staff is knowledgeable about diet, nutrition, exercise and complete health of body, mind and spirit. Our staff will work with you on improving your overall state of wellness, starting with a thorough assessment of your present health status, diet, medications. Our Doctors help you find ways to implement the lifestyle changes that will improve your health, and develop a long-term lifestyle program that will promote your life-long well-being.