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Enhanced external counterpulsation (EECP) is a treatment for chronic, stable chest pain ( angina ). Angina happens when there is not enough blood and oxygen being pumped to the heart to support the work it is doing.

Cuffs (similar to blood pressure cuffs) are placed on the legs. These cuffs inflate (fill with air) and deflate in rhythm with the heart to push blood back toward the heart. EECP increases the amount of blood reaching the heart so the heart does not have to work so hard. This helps improve circulation.

The Cardiovascular System

EECP pushes blood back toward the heart to reduce the heart's workload.

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You may have EECP to treat angina if:

• Your medicines are not working well enough
• You are not a good candidate for surgery
• Your doctor wants you to try nonmedical alternative before considering surgery
• You have had surgery but are still having chest pain

You may have EECP to treat heart failure if:

• Your heart function, known as ejection fraction (EF), is less than 35% and you are not having active symptoms of shortness of breath—Talk to your doctor about your EF.
• You are still having symptoms after being given all appropriate medicines for your heart

The benefits of EECP may include:

• Decreased need for angina medicines
• Decrease in symptoms of angina
• Ability to do activities (eg, exercise) without angina
• Improved heart function if a lack of oxygenated blood flow is a problem

Complications are rare, but no procedure is completely free of risk. If you are planning to have EECP, your doctor will review a list of possible complications.

The most common complication is skin irritation due to the inflatable cuffs. You may have:

• Chafing
• Bruising or blisters
• Bleeding if your blood is too thin
• Leg or waist pain
• Worsening of heart failure in people who have certain heart rhythm abnormalities

You should not have EECP if you are pregnant or have any of these conditions:

• Severe heart failure
• Certain heart valve problems (e.g. significant aortic insufficiency or regurgitation )
• Problems with heart rhythm ( arrhythmias )
• High blood pressure you cannot control with medicines
• Blockages in the veins or arteries of your legs ( peripheral arterial disease )
• Recent heart catheterization
• Severe chronic obstructive pulmonary disease (COPD)
• Aneurysm (bulging) of the aorta or dissection (tear)

After arriving home, contact your doctor or call for medical help right away if there are signs that your angina is getting worse:

• Severe chest pain (feels tight or heavy)
• Shortness of breath
• Numbness or tingling in shoulder, arm, or wrist
• Nausea
• Symptoms not relieved with medicine

In case of an emergency, call for medical help right away.