August 28, 2008

External Pump for Heart Disease

By Dr Donohue

Q: I am under treatment for angina. When I have an attack of chest pain, I usually can get rid of it with nitroglycerin. My neighbor, exactly my age, has the same thing: coronary artery disease with angina attacks. His doctor is treating him with leg pumps. He says he has had no angina since he started the treatment. Would this help me?

A: The procedure, enhanced external counterpulsation, has been around for 10 years.

A series of cuffs, like blood pressure cuffs, is wrapped around the patient's legs. At a very precise moment in the heart cycle, the cuffs are sequentially inflated, with the lowest cuff inflated first. The pumping maneuver increases blood flow back to the heart and to the heart muscle. Angina is chest pain that comes on with activity. It indicates that one or more of the heart arteries have a blockage. People with artery blockage get enough blood to the heart muscle when they're resting, but, when they are active, the blockage prevents the increased flow required for the extra effort the heart must make. The result is the chest pain called angina.

Some people who have undergone a series of EECP treatments have fewer attacks after the treatment, and some have even discontinued medicine for angina.

EECP has yet to win universal approval. People who judge the effectiveness of medical treatments want more evidence before they recommend it for everyone. Would it work for you? Only a trial with it will tell you.

Q: There's a yellow streak on both my eyelids. What is this? Does it mean eye trouble?

A: Those streaks are xanthelasmas (ZANN-thul-AS-muhs), an aggregation of cells filled with cholesterol. In half of people with them, they indicate high blood cholesterol or high blood triglycerides. If you haven't had a check of your cholesterol or triglycerides, you should have one.

They are not a sign of eye trouble. If you find them cosmetically distressing, they can be removed.

Q: What's a "chemical" depression? I have two relatives who say that's what they have.

A: Brain cells communicate with each other through chemicals with names such as dopamine, serotonin and norepinephrine. One current and popular theory about depression cites an imbalance of one or more of these chemicals as the cause. Antidepressants restore the normal balance.

Dr. Paul Donohue appears Mondays. Write to him at P.O. Box 536475, Orlando, FL 32853-6475.

Originally published by Dr. Donohue, North America Syndicate Inc.

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