Title : Enhanced external counterpulsation treatment in patients with refractory angina pectoris
Abstract:
Enhanced External Counterpulsation (EECP), a treatment method used in heart failure and coronary artery diseases, is an evidence-based alternative noninvasive treatment. In addition, patients show good compliance with EECP. In this treatment carried out by a professional team, a cardiologist, a trained and experienced nurse and an assistant physician are included. The EECP device used in the treatment consists of a control console, a patient treatment table, an air compressor and three sets of cuffs. The cuffs are wrapped around the lower leg, upper leg and hip areas. During the treatment, the systolic and diastolic pressure waves of the patient, who are connected to the electrocardiogram, are followed by the finger probe. The cuffs are inflated sequentially during diastole by filling with air through the microprocessor and computer in the system. Thus, it increases the blood flow to the heart and provides oxygenation of the heart muscle. During systole, the cuffs descend simultaneously, reducing the preload of the heart. This reduces the workload of the heart. EECP is the safe and probably most appropriate treatment modality, especially for patients presenting with symptomatic Coronary artery disease who are not amenable to further revascularization. As a result of the literature review, it has been revealed that EECP consistently reduces angina pectoris and extends the time until exercise-induced ischemia. In addition, it is reported that the dependence on nitroglycerin use for frequent chest pain decreased and the quality of life increased in symptomatic patients with stable angina. Patients with refractory angina pectoris experience recurrent symptoms despite receiving medical treatment. These reduce their functional capacity, which consists of psychological distress and health-related quality of life. Symptoms seen in these patients due to EECP treatment decreased, their physical capacity levels increased and their cardiac anxiety decreased. Accordingly, the physical activity levels and life satisfaction of the patients increased. The reviewed literature also reported a small number of adverse events related to EECP. Although EECP seems to be a safe and well-tolerated treatment option in patients with refractory angina, nurses need to be careful and flexible to prevent adverse events and terminate treatment early.
Key Words: angina pectoris, coronary artery disease, Enhanced External Counterpulsation, nurse, patients
