CASE I
History:
65yrs old, known case of coronary artery disease, diabetes and Hypertension. Admitted in Aga Khan University Hospital in 1992 first time due to Myocardial infarction (Heart Attack).
He again admitted in 1997 and 2003 due to unstable angina attacks and advised for Bypass surgery but he refused for operation and remained on medication.
Before EECP he was unable to walk even up to bathroom, every day he was bound to stay at bed and taking sublingual nitrate for temporary relief of angina.
Investigations:
His angiogram was performed on diagnosed as three vessel disease with severely diffused disease and ejection fraction was 33%
Echocardiography was done, which showed severe LV dysfunction with segmental wall motion abnormalities with EF15-20%
Result:
After getting a 35 hours course of EECP treatment, now he is able to walk, regularly going to their business and free from angina .Now he is taking a few medicines only to control blood pressure and aspirin. His EF is improved from 15-20% to 50-55%.
CASE II
History:
27-year-old male patient with family history of hyperlipidemia and diagnosed case of exertional angina.
Investigations:
1.5-2.0 mm horizontal ST segment depression on exercise treadmill test
100 percent occlusion of mid-right coronary artery
100 percent occlusion of mid-left anterior descending coronary artery
95 percent blockages in both proximal mid-right coronary artery and small branch of left circumflex coronary artery
Considered not suitable for interventional therapy
Results:
After getting a 35 hours course of EECP treatment:
Angina was completely eliminated at normal levels of exertion
Post-treatment radionuclide stress testing showed marked improvement in myocardial perfusion
CASE III
History:
72-year-old male patient with two previous myocardial infarctions and bypass surgery.
Investigations:
Ischemic cardiomyopathy
Progressive angina with minimal exertion
100 percent occlusion of proximal portions of all three native coronary arteries
Maintained on medical therapy
Result:
After getting a 35 hours course of EECP treatment:
Left ventricular ejection fraction (LVEF) increased by 80 percent from baseline
Functional status and chest pain improved markedly
Post-treatment stress test showed improved cardiac perfusion and function
CASE IV
History:
72-year-old male patient with history of diabetes, gout, hypertension, triple-vessel coronary artery disease (CAD).
Investigations:
Stable angina
Previously declined bypass, maintained on medication
Stress test suggested progression of CAD
Severe hypoperfusion of inferior wall and apex with stress perfusion
Results:
After getting a 35 hours course of EECP treatment:
Post-treatment stress testing revealed marked improvement in myocardial perfusion
Increased exercise ability
Chest pain symptoms were eliminated
Patient no longer required nitroglycerin
