Indications & Contra Indications   

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