Related Experiment Video
Updated: Nov 22, 2025
Increasing Pulmonary Artery Pulsatile Flow Improves Hypoxic Pulmonary Hypertension in Piglets
Published on: May 11, 2015
Enhanced external counterpulsation: A unique treatment for the "No-Option" refractory angina patient
Jose Caceres1, Patricia Atal1, Rohit Arora2
1Buena Park Heart Center, 8585 Knott Ave, #101, Buena Park, CA, 90620, USA.
Insights
Enhanced external counterpulsation (EECP) effectively treats coronary artery disease (CAD) symptoms. This noninvasive therapy reduces angina, improves exercise tolerance, and enhances quality of life for patients with refractory angina.
Area of Science:
- Cardiology
- Noninvasive Cardiovascular Interventions
Background:
- Coronary artery disease (CAD) is a leading cause of mortality.
- Guideline-driven measures are often insufficient for patients with refractory angina.
- Enhanced external counterpulsation (EECP) offers a noninvasive therapeutic option.
Purpose of the Study:
- To review the efficacy of EECP for symptom relief and quality of life improvement in CAD patients.
- To evaluate EECP as a treatment for refractory angina.
Main Methods:
- Literature review of existing published studies on EECP.
- Analysis of safety and efficacy data from reviewed literature.
Main Results:
- EECP consistently reduces angina pectoris and nitroglycerine dependency.
- It extends time to exercise-induced ischemia and increases maximum workload.
- EECP significantly improves quality of life in symptomatic stable angina patients.
Conclusions:
- EECP is a safe and effective treatment for symptomatic CAD.
- It is a viable option for patients not amenable to further revascularization.
- The therapy is well-tolerated with minimal adverse events.
What Is Known And Objectives:
Coronary artery disease (CAD) is the leading cause of death in the United States. For patients on whom guideline-driven measures have been tried, enhanced external counterpulsation (EECP) is the only truly noninvasive and safe intervention for which a reduction of angina symptoms and nitrate use, increased exercise tolerance, and improvement in myocardial ischaemia have been shown. The objective of this study was to demonstrate, by way of literature review, the efficacy of EECP as a treatment modality for the relief of refractory angina and improvement in quality of life in CAD patients.
Methods:
This article reviewed the safety and efficacy of EECP in patients with refractory angina, by conducting a sweeping search and analysis of existing published literature.
Results And Discussion:
Critical review of a multitude of studies revealed that EECP consistently reduces angina pectoris, extends time to exercise-induced ischaemia, decreases dependency on nitroglycerine for frequent chest pain, increases maximum workload, and improves the quality of life in patients with symptomatic stable angina. The literature reviewed also indicated that EECP is well-tolerated by the vast majority of patients, with relatively few adverse events reported.
Conclusion:
The present study suggests that EECP is a safe and likely best available method of treatment for patients presenting with symptomatic CAD not amenable to further revascularization.
Related Concept Videos
01:26Angina IV: Management
01:20Angina V: Nursing Management
01:27Angina II: Classification
01:27Peripheral Artery Disease III: Interprofessional Care
01:22Heart Failure VI: Adjunct Therapies
01:26Treatment for Pulmonary Arterial Hypertension: Receptor Tyrosine Kinase Inhibitors and Calcium Channel Blockers
TKIs, such as imatinib (Gleevec), are particularly effective in tackling the growth and mitogenic factors that become upregulated in PAH patients. These factors contribute to the...