University of Virginia Health System

U.Va. Offers New Treatment for Chest Pain

Angina, which affects more than 7 million Americans and presents most commonly as chest pain, occurs when blocked coronary arteries limit blood flow to the heart muscle. Most patients with coronary artery disease are candidates for bypass surgery or balloon angioplasty, said Dr. Ian Sarembock, professor of medicine and director of the U.Va. Coronary Care Unit. But for patients who are not candidates for traditional therapies or in whom traditional therapies have not relieved angina, EECP may offer relief.

Previous studies suggest that a significant number of patients who received EECP were able to exercise 60 to 70 percent longer before experiencing debilitating chest pain, Sarembock said. EECP also improved the patients' quality of life for as many as six months following treatment.

The EECP device is made up of a computer and three pairs of inflatable cuffs similar to a blood pressure cuff, Sarembock said. The cuffs are fitted around the patient's calves, thighs and buttocks. The computer monitors the patient's heartbeat by reading the heart's electrical signals. During the resting phase of the heartbeat, when the heart relaxes and fills with blood, the cuffs inflate in rapid sequence. These balloon inflations facilitate blood flow from the legs to the heart, which improves blood flow to the heart muscle. Patients undergo 35 one-hour treatments over a seven-week period.

Lawfey Maupin, 60, of Charlottesville, was one of the first patients at U.Va. to receive EECP. Before undergoing the treatment, he experienced several episodes of chest pain every day. After EECP, he said his life has improved considerably and he's only had one episode of chest pain in four weeks. I can't remember the last time I was able to chase my livestock across the pasture without chest pain, he said. I can walk up steps. I can play with my grandchildren longer. It's one of the best things I've ever done.

In fact, Maupin said that last week, one of his tractors accidentally ran over on a friend who was helping him. I had to run over and cut the tractor off and move my friend away from it and then run inside and call the rescue squad, he said. I was the only one there. Before the EECP treatments, I don't think I would have been able to do all of that. I might not have been able to help my friend.

At this time, physicians aren't quite sure how EECP reduces angina. It may stimulate the growth of new blood vessels around the heart, which could improve blood supply to underperfused areas of heart muscle, Sarembock said.

For more information, contact Dr. Ian Sarembock, professor of medicine and director of the U.Va. Coronary Care Unit, at (804) 924-2420, or Ellen Longmoore, EECP program director, at (804) 243-4664.

April 21, 1999