Abstract

Modern life-style is responsible to increasing number of CAD patients worldwide. Coronary Heart Disease has come out as the biggest killer of human

population in past 2-3 decades. CAD / CHD, is basically a systemic disease in which a part or parts of myocardium do not get proper blood supply through

coronaries, due to blockages or narrowing of the vessels. Surprisingly, in spite of the large number of morbidity & mortality caused by this disease, the measures to check or reverse the disease process are either not sufficient or not in the proper direction. Initially CABG, then due to high morbidity and mortality followed by so many post-surgical complications, focus was shifted towards balloon Angioplasty, BM Stents, DES/Medicated Stents, but due to higher rates of restenosis & other complications, now DEB (Drug Eluting Balloon) & bio absorbable stents are highlighted. Now in 21st Century External Counter Pulsation (ECP) has come into light as the first Non-invasive, Non-pharmacological USFDA approved treatment modality, which is performed without hospitalization as an outdoor procedure, without any anesthesia, without any risk, without any peri or post procedure complications and without pain. Patients treated with ECP therapy, in various trials and in thousands of ECP centers all over the world, all the ‘ECP Experts’ have demonstrated marked improvement in all aspects in terms of functional angina class, increased exercise tolerance, and a reduction in nitroglycerin use also in all kind of myocardial perfusion assessment like MPI scan by SPECT, Stress ECG and PET scan. These benefits have been demonstrated in terms of increased myocardial perfusion & enhancement in LVEF, remain durable in many patients from 5 to even 12 years after treatment. ECP has come out as a proven non-invasive treatment modality for Stable CAD & Heart Failure patients. It fulfills all the criteria for a successful CAD / LV dysfunction treatment as defined by ACC/AHA in their published Guidelines. By this unique treatment, presently we are treating patients of CAD/ LVF/ CHF those who are either Unfit or Unwilling for Invasive or surgical revascularization. ECP is a very good choice, also when it remains a big confusion in the mind of treating consultant, whether, to send any particular patient for PCI or not. Similarly patient who developed re-stenosis or re-blockages after Stent implantation, then ECP remains very good option to save that patient from the risk and complications of CABG. In post CABG cases, ECP is the safest option and provides very good all round symptomatic relief & hemodynamic improvement. ECP remains the only treatment option for those CAD patients who are having diffuse or micro-vascular disease including Diabetics & women. ECP treatment provides numerous all round benefits including even Non-cardiac improvements to all the cardiac patients. Now, it is the right time to change our mind-set for the benefits of CAD patient community and provide them the best & safest treatment available in present days, i.e. ECP, which provide lot of all-round benefits and no harm.