oversized blood pressure cuffs to your calves and
thighs, then inflate them in sequence every 10 seconds
The squeezing sends your blood coursing toward your
heart more forcefully than your body normally could.
That’s the gist of an increasingly popular
treatment for angina, the chest pain caused by poor
blood flow to the heart muscle. A growing number of
doctors are promoting ‘‘enhanced external
counterpulsation,’’ or EECP.
Although the jury is still out about whether EECP is
as good as more established heart treatments, some
patients clearly can benefit.
Howard Cherney, 73, a retired Tamarac, Fla., engineer
who had a heart attack 19 years ago, says he can now
walk 2 1/2 miles a day without a twinge of chest pain
‘‘I was getting angina just from sitting in a
chair watching TV,’’ Cherney says. ‘‘I
couldn’t even walk to my car.’’
Cherney’s doctors recommended bypass surgery or a
balloon angioplasty to take care of blockages in his
heart arteries. But he was nervous about complications
from the operations. Against advice, he got EECP this
spring from Dr. Dimitri Pyrros in Margate, Fla.
The therapy has been proved effective in reducing
angina in most heart patients, with few side effects and
a lower cost than other alternatives.
Patients lie on a table while the cuffs squeeze their
legs for an hour. They must go five days a week for
The theory is that forcing blood to the heart reopens
small, unused blood vessels that serve to detour blood
around the blocked artery. Some researchers say EECP
leads to growth of new vessels, but that remains
‘‘We’ve had patient after patient come in who
were told, ‘There’s nothing more we can do for
you,’’’’ says Pyrros, who bought an EECP machine
two years ago.
EECP has many skeptics, especially among heart
specialists who favor medicines, bypass surgery and
angioplasty, which involves inflating a balloon to open
‘‘I view (EECP) as a secondary treatment,’’
says Dr. Howard Bush, cardiology chairman at Cleveland
Clinic in Weston, Fla. ‘‘You better have plan A and
plan B. This is plan C.’’
The studies are not yet overwhelming and convincing,
he says. Medicare and the American College of Cardiology
recommend EECP only if mainstream treatments fail or if
the patient cannot tolerate them.
Dr. Mark LaPorta, an internist who supervises EECP at
the HeartLife center in Aventura, Fla., contends that
more studies will prove that it should be used as a
first-line treatment. The cost is about $5,000 compared
to about $8,000 for angioplasty and $25,000 for bypass.
The side effects are few. Some patients experience
rashes, blisters or skin irritations, a danger
particularly for diabetics with poor circulation.
More practically, the seven-week treatment may
frustrate patients who lack patience and drop out early,