What is External Counter Pulsation (ECP)?
It is a non-invasive procedure that may reduce the symptoms of chronic angina (chest pain or shortness of breath) by stimulating the formation of small branches of blood vessels (collaterals), which circumvent the blocked arteries. At times, ECP may be an alternative to bypass surgery or angioplasty.
What are the benefits?
The benefits of ECP are varied. Studies have shown a decrease in the incidence of anginal episodes, hospitalization for angina, and anti-anginal medication use, along with patients' statements of more energy and reduced shortness of breath.
How does ECP work?
Air is pumped into a series of cuffs placed on your calves, thighs and buttocks. The cuffs compress your lower extremities in sequence (like a wave), which increases blood flow back toward your heart. The inflation of these cuffs is timed to your heartbeat so the blood arrives at precisely the time the heart relaxes. A fraction of a second before your heart beats again, the cuffs are instantaneously deflated, enabling the blood in your heart to be pumped (systole), with minimal resistance, into your now empty blood vessels. This decreases the amount of work your heart must perform.
What happens during ECP Therapy?
- Your technician will ask you a series of questions at each session.
- They will obtain your weight, blood pressure, blood sugar (if you are diabetic), check your lung sounds and evaluate your skin condition.
- You will change into stretch tights that are provided for you.
- Three electrodes will be applied to your chest to provide an EKG signal so that the system will be properly timed to your heartbeat.
- Two sensors will be clipped to your fingers to provide us with a reading of your oxygen and give us a blood pressure tracing. This is to determine the proper setting to maximize the effect of the therapy.
- Next, the technician places the cuffs around your calves, thighs and buttocks. They will squeeze you similar to a blood pressure cuff.
- The treatment itself lasts for one hour. You will generally be here about 1.5 hours. A television is provided, and you may have family stay with you. Many people actually nap during their therapy.
How will I feel during and after my ECP Therapy?
Most patients describe the treatment as a vigorous massage. They also say that after you get used to it, sleeping is very easy. Right after finishing a treatment, many are energized or invigorated, but some feel a little tired.
How long do I attend ECP Therapy?
ECP sessions are 1.5 hours Monday - Friday for seven weeks. Interruptions in the daily sessions are not good and should be avoided if at all possible.
Does my insurance cover ECP?
This therapy is covered by most insurance plans, including Medicare.
How to I start?
Talk with your physician to determine if ECP Therapy is the right choice for you. Your physician will know if you have any contraindications to receive ECP Therapy. The office will then send an order to our department, and we will call you. You may also contact us for any questions that you may have: 498-8396.
Pulmonary Function Testing
Jersey Community Hospital has a new state-of-the-art pulmonary function testing machine. This is an easy method of testing that gives reliable indications of lung function. Since early detection and treatment may alter the course of the disease, public health officials are trying to encourage routine screening for COPD. They would like to see the testing done as part of a routine health examination for people who are in high-risk groups, such as those with a history of smoking, those with respiratory symptoms and anyone over the age of 45. An especially important group to test is people with asthma.
What is a Stress Test?
A stress test allows doctors to learn how well your heart functions when it is made to work harder. This test can help detect heart problems that may not be apparent at rest. The exercise test is done while you walk on a treadmill. During the test, an electrocardiogram (ECG) records the electrical activity of your heart.
What does it show?
Even if your heart functions well at rest, the blood supply to the heart may not be sufficient to meet its needs when its workload is increased. The exercise test is used to see how well your heart functions during exertion. If your physician has ordered a nuclear stress test, you will receive an IV injection of a substance, known as a tracer, to produce images of the heart muscle. The nuclear scan helps to determine if areas of the heart are not receiving enough blood. Throughout the test, several types of information are being recorded:
- How long were you able to exercise?
- Did you have significant symptoms? (If you develop chest pain or discomfort, or become extremely short of breath, this may indicate a heart problem.)
- What happened to your heart rate and blood pressure? (An abnormal heart rate, i.e., too fast or too slow, or a fall in blood pressure during exercise may indicate heart disease.)
- What did the ECG show? (Certain patterns in the ECG tracing may indicate that the heart muscle is not getting enough oxygen-rich blood. Sometimes, the ECG during exercise shows abnormal heart rhythms.)
Doctors may order an exercise stress test to:
- Diagnose the cause of chest pain.
- Determine the level of heart function in people with heart disease.
- Evaluate the efficacy of treatments such as medications or heart procedures.
- Look for abnormal heart rhythms that may develop during exercise.
- Determine the level of exercise that is right for you.
Preparing for the test:
- Do not eat or drink for four hours prior to the test. (If you have diabetes and take medication for it, get special instructions.)
- If you are currently taking heart medications, check with your doctor. He or she may ask you to stop certain medications a day or two before the test.
- Wear loose and comfortable clothing that is suitable for exercise. Also, wear comfortable walking shoes or sneakers.
- Before the test, you'll be given a brief explanation of the test and you'll be asked to sign a consent form. Feel free to ask any questions about the procedure.
- Several electrodes (small sticky patches) will be placed on your chest to obtain an ECG. Men may need to have areas of their chest shaved, to ensure that the electrodes stay in place.
- If you are having a nuclear stress test, an intravenous (IV) line will be inserted into a vein in your arm, to allow injection of the tracer.
What happens during the test?
The treadmill starts slowly, and then the speed and incline are increased gradually. Your blood pressure will be checked every few minutes, and your ECG will be carefully watched for abnormal changes.
Be sure to report any symptoms, such as chest pain or discomfort, dizziness, or severe shortness of breath. Try to exercise for as long as you are able to because it increases the accuracy of the test.
The test usually continues until you reach a "target" heart rate based on your age. The test may end when you experience significant symptoms, become too tired or when the ECG shows abnormal patterns.
After the exercise portion of the test is over, you'll be helped to a chair or bed. Your blood pressure and ECG will be monitored for another 5 to 10 minutes while you recover.
During a nuclear stress test, you will also have images taken of your heart, in the x-ray dept. You will be lying down on a special table under a large scanning camera. During imaging, the camera takes pictures of your heart at various angles for approximately 20 minutes. This will be done at rest and after the exercise portion of the test.
For patients that are unable to exercise adequately (i.e., back or knee problems), a medicated stress test may be performed. A medicine, generally Adenosine or Dobutamine, will be injected slowly through an IV, instead of using the treadmill. These medications produce an effect on the heart similar to exercise. You will receive further prep instructions for this test.
Is the exercise test safe?
The exercise test is generally safe. A small amount of risk does exist, however, because it stresses the heart. Possible rare complications include abnormal heart rhythms and a heart attack. Experienced personnel are available to handle any emergency. During a nuclear stress test, the radiation exposure is small, and the doses used are safe.
When do I receive my test results?
The doctor conducting the test may be able to give you preliminary test results before you leave. Or, your own doctor will discuss the test results with you during a future office visit. The information gained from the exercise test helps your doctor make an accurate diagnosis and develop a treatment plan that's best for you.
For any questions, please call the Cardiopulmonary Department at (618) 498-8396.