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Indications & Contra Indications   arrow

Indications

1.   Patients with angina equivalents who:

  • Are considered inoperable or at high risk of operative / interventional complications.
  • Suffer from micro vascular angina (cardiac syndrome X)
  • Have coronary anatomy unsuitable for catheter-based or surgical revascularization.
  • Have co-morbid conditions / illnesses that increase the risk of revascularization procedures (e.g. Diabetes, heart failure, pulmonary disease, renal dysfunction)
  • Have Left Ventricular Dysfunction (LVD) with an Ejection Fraction <35%
  • Are unwilling to undergo additional invasive revascularization procedures.
  • No longer respond to medical therapy.
  • Restrict their activities to avoid angina.
  • Cannot afford angioplasty and bypass surgery


2.   Patients who have suffered / suffer from myocardial infarction (heart attacks)

3.   Heart Failure patients who:

  • Have ejection fraction of <40%
  • Have ischaemic or idiopathic cardiomyopathy
  • Have co-morbid conditions that increase the risk of complications of revascularization procedures.
  • Diabetic patients who have a greater risk for post-procedural complications. (due to small vessel disease)
  • Elderly patients at high risk for morbidity and mortality associated with invasive coronary interventions


ECP can also be performed on patients who want to undergo treatment as a prophylactic (preventative) procedure to ensure a healthy lifestyle.

Contraindications

  • Severe arrhythmias
  • Bleeding diathesis
  • Active thrombophlebitis
  • Severe lower extremity vascular occlusive disease
  • Presence of a documented aortic aneurysm requiring surgical repair
  • Pregnancy
  • Severe pulmonary hypertension/oedema (pulmonary artery > 50 mm Hg)
  • Uncontrolled systemic hypertension (> 180/110 mm Hg)
  • Severe aortic insufficiency
  • Warfarin therapy with INR>3.0