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Problems After Coronary Artery Bypass Graft (CABG)

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Current Postings on This Page (65):

• Amy in Punta Gorda - As we're sure this woman has been told, smoking is a major risk factor in all forms of heart disease. It inflames the lining of the arteries and causes all sorts of other complications. If she is in AFib, then blood thinners are necessary to prevent blood clots that may travel to the brain, causing stroke. The bleeding issues you report present a complication and her AFib needs to be managed better. We would recommend a thorough workup by a cardiologist - there are newer drugs for controlling AFib that may be helpful.
Angioplasty.Org Staff, Angioplasty.Org, July 18, 2022

• 76 yr old woman smoker of 60 years, continually having ischemic strokes, thrombosis, lots of stenosis, now hemorrhage from blood thinners,a fib clamped properly during off pump surgery. Why does her heart keep throwing blood clots?
Amy, Punta Gorda, Florida, USA, July 12, 2022

• M in Devon - Stenting is done by an interventional cardiologist and not a surgeon. So Dr. Cha, the surgeon, would not be the doctor implanting the stent. We suggest that you, your husband, Dr. Cha and the interventional cardiologist discuss this issue together. Or at least Dr. Cha and the cardiologist should, to determine the risk involved.
Angioplasty.Org Staff, Angioplasty.Org, July 31, 2016

• My husband aged 76 had a CABG op 18months ago. He was progressing well but the last 2 months he has been very weary and needs sleeps during the day to get some energy. He goes very gray in the face. Once he has had a rest he looks fine again for another couple of hours. The operation was long 8hours on low oxygen, that has left Ray with no balance when standing and walking, hence he needs crutches to get about. The surgeon had to bypass up towards the shoulder before it settled as the vein kept breaking down. The surgeon Mr. Cha is amazed that my husband got through it.... He is to have a Stent procedure soon but Mr. Cha seemed worried to intervene. The worry is that if his veins are weak and the narrowing of the Artery is in the bypass where a stitch has slightly narrowed the artery.... Although he can see my husband has no quality of life right now. Could you give us any advice on the Stent procedure please?
M, Devon, England, July 31, 2016

• I am a 33 year old female, had a heart attack three days after my 31 birthday and the next day had double bypass two months later had been opened up again due to an infection and had a wound vac for six months...chronic pain fear of dying all the time and drs look at me like I'm crazy. I know my body something isn't right help me.
33 year old female chf 2x cabg , Orange County, California, USA, June 14, 2013

• Subramanian in Virginia -- Perhaps a dermatologist or plastic surgeon many be able to alleviate some of the discomfort from the scar. As for getting another CABG, why would you do that? Do you have symptoms? Have any tests shown a perfusion deficit (lack of blood flow/oxygen to the heart muscle)? Also not sure what a "preventative" CABG is. Guidelines indicate revascularization (either angioplasty/stents or CABG) only in a symptomatic patient who has documented ischemia and where there is a good reason to believe that revascularization will benefit the patient.
Angioplasty.Org Staff, Angioplasty.Org, May 24, 2013

• I underwent a CABG (preventive) in May 2006 in India and taking regular Nebistar 5 mg and Ecosprin AV 75 regulary. I am Ok and my TMT continues to be negative. I am also not diabetic. However the Keeloid/Scar is giving me irritation and pain. Some times I do get pain in the chest. I often confuse this with the cardiac. Is there any remedy for this pain? Will I need to go for another CABG as 7 yrs completed after the earlier CABG?
Subramanian, Arlington, Virginia, USA, May 23, 2013

• Thomas -- There is some information from other patients in our Forum Topic on EECP.
Angioplasty.Org Staff, Angioplasty.Org, May 15, 2013

• Just how does EECP work without surgery? I am getting desperate for some type of relief. I had 5 grafts of which two have collapsed. I have a hard time walking from my car to my office. My open heart surgery was in 2010. Since I have been back to my doctor several times, it's like he has given up on me.
Thomas, Georgia, USA, May 14, 2013

• Mifraz -- Have you consulted yur cardiologist? You should. If you are having returning angina, shortness of breath (SOB), etc. he/she may want to run some tests to see if your bypass is still doing what it's supposed to. Even if only to reassure you that all is okay.
Angioplasty.Org Staff, Angioplasty.Org, April 20, 2013

• 55 Male - had triple bypass in Feb 2011. Doctors admitted my surgery was successful and i was sent home, however since then i am experiencing severe pain on the left around the heart which sometimes runs down to my left wrist. I do regular exercise and am careful with my diet. Have done several exercise ECG's and Echo since but all showed good results. I am now short of breath as well and the pain is constant and comes so many times each day even when I am relaxed or seated. I am really depressed and disturbed mentally and physically and am unable to concentrate on my future. I am worried as i have a very young family. Can some good friend with similar symptoms or a Medical Officer experienced in this syndrome please help me to do what is needed to get out of this and live a normal life. Thanks.
Mifraz, Colombo, Sri lanka, March 24, 2013

• I had a robotic bypass in 12/2009 . Have recently found out it was connected to a branch of the artery and not the artery it was supposed to be connected to .I'm now facing a 'do -over' due to ischemia from lack of blood flow .Any others out there with this occurrence. By the way.... they forgot to check and clear my left carotid artery prior to the CABG and I had a stroke 2 days post op . Other than the occasional seizures and weakness in my right side especially when I'm tired. Life's grand!
Frederic K, Edgartown, Massachusetts, USA, January 11, 2013

• Susan from Alabama -- Have you contacted the surgeon who did the bypass? He/she should be made aware of this and would be the best source of information about this. Is the infection being treated?

And Cazz in London -- it's very very good that your partner has stopped smoking. The life of a saphenous vein bypass graft, (SVG) which is taken from the leg, is about 10 years. His grafts obviously had more rapid progression of the disease (possibly due to smoking). It may be possible to use angioplasty and stents to reopen these, or even re-open the native artery. This is what happened with U.S. President Bill Clinton. Perhaps you might want to accompany him to his appointment with the cardiologist so you understand better his situation and can provide support for his decision process.
Angioplasty.Org Staff, Angioplasty.Org, November 7, 2012

• My 69 year old brother had 5 bypass surgery 2 weeks ago. He was doing fine until his leg swelled up quite a lot. He has diabetes (i don't know if that has anything to do with or not). I am very worried, they told him at er that he has an infection. Please tell me what could have gone wrong.
Susan, Birmingham, Alabama, USA, November 6, 2012

• My partner had a quadruple by pass 5 years ago, he carried on smoking and now has been told two are blocked and his heart is quarter damaged and not working he will not talk about it and I need to know what is happening, he came out of hospital but wont tell me what they said other than they are reviewing his case. He has stopped smoking. I have just moved in with him after dating him for three years. Please help me understand
Cazz, London, U.K., October 30, 2012

• I had a quad bypass 12 years ago at age 60. All went well and in 1-1/2 month I walked the Portland Marathon. I have continued to walk, hike and bicycle except for a few months in the dead of winter. Except for two years ago.I am now doing exercise classes to rebuild my muscles that atrophied after I was given Crestor and Zocor for about 8 years. I developed severe side-effects that resembled Parkinson's. I felt so bad that i basically laid on a couch for 80 percent of my waking time. I was in desperate condition when I discovered the link between Crestor and false diagnoses of Parkinson's. I quit Crestor and felt immediately better. I resumed my activities and have lost 30 lbs and regained much strength and balance. I am now rebuilding my life but concerned about how much damage the incorrect diagnosis did. The Crestor/Zocor debacle is due to the FDA allowing the drugs to be put out on the market before doing long term testing.
joal, Eugene, Oregon, USA, August 13, 2012

• I had 5X open heart (CABG) in May 2009. Except tightness in chest I did not felt any other problem. I drive 4 W, no breathing problem. But for last two months or so I am suffering from pain in ribs particularly in right side and it becomes more when i sit for longer time & unbearable while changing side during sleep...Thanks pain has not passed on to left side so far..Is there any cure? please help...
Binod Jha, Indian Bank Ahmedabad, India, August 13, 2012

• 57 year old male.. had quintuple bypass surgery in late 2007. 6 months after bypass the graft bypassing the circumflex occluded and a stent was put in the circumflex. That was the 5th stent into that artery . At same time saphenous vein graft was closing down and stent put in that. I have 6 months of symptoms such as shortness of breath, fatigue and xiphoid lower sternum pain but no angina. After 6 months it clears up ,then 6 months symptom free, then 6 months symptoms again. Fast Forward. Last year I had 2 more angioplasties , but since bypass ,it DOES NOT relieve symptoms even though they were closing. Same vein graft Doctor thinks it is too small for the area and it bends at 90 degrees pinching it shut. More work on it they fear it may perforate. With other circumflex 6 stents make it impossible to do more. My main LAD is open and PATENT and went through ECEP, which worked for a while. I exercise regularly but feel pain often after but not during. IS IT POSSIBLE THAT SO MANY INTERVENTIONS, STENTS AND ANGIOPLASTIES ON THOSE 2 (GRAFT AND NATIVE ARTERY HAS CAUSED PERMANENT INFLAMMATION. If I leave those 2 buggers closed cause they won;t stay open will I have a heart attack. CONFUSED
57 male, Winter Springs, Florida, USA, June 20, 2012

• Nirmal in Mumbai -- His breathing problem is most likely sleep apnea, which can occur after surgery. There are several different treatments/devices that may help with this. As for his swollen leg, not possible to tell what that might be, but we recommend seeing his cardiac surgeon or cardiologist to get specific help for these issues.
Angioplasty.Org Staff, Angioplasty.Org, March 31, 2012

• My husband is 57 years old. He had a 3 x CABG 9 months ago. He complains about breathing problem at night and he has a swollen leg which has not cured yet.
nirmal khanna, Navi Mumbai, Maharashtra, India, March 26, 2012

• I was 36 in 2002 when I had my first heart attack and had a stent put in my right coronary artery. I have had 7 more heart attacks since then. My last one resulted in quad bypass in 2010. After recovery I still had problems, so a year later went in for a check up and due to results the DR. ordered another angiogram which showed 2 more arteries 50 and 65% blocked and several veins on my heart that are completely blocked. they wont do anything about the arteries until they are 75% blocked and the small veins they can do nothing about. I can't do anything without feeling like I"m going to have a heart attack, go up and down stairs, walk to the mailbox, make love to my wife. The Doctor acts like I should be fine and everything should be normal, the depression and the fear that I am gonna drop dead at any moment consume my every thought. When I sleep I dream I"m having a heart attack. so I have not had more then 2 hrs of uninterrupted sleep in months. I am constantly fatigued and short of breath. I cant even do the simplest exercise. I feel so hopeless!!!!! I don't know what to do!!!! Thank you for letting me share and vent. Good luck to all of you that are having problems too.
Donnie, Indianola, Iowa, USA, February 13, 2012

• I am 48 yr old Type 1 diabetic on insulin pump..I had Quad heart bypass in 07..have done well.. a lot of other medical things going on as well...but I have been experiencing chest pain off & on for 3 wks daily the past week..I am scared and have made app w/cardio dr...for next week...Is this common to have pains again after bypass so soon?
LAB, Marion, Illinois, USA, February 10, 2012

• My dad 65 yo w/m had CABG 7 years ago. Has had chronic pain for the whole 7 yrs. He can touch the worse spot and press down and feel the pain. He says its right here and touches it. Been to every doctor looking for relief he has never returned to any kind of work due to the pain. sternal non union ruled out, tried the nerve burning from the back into the spot. The only answers from doctors in TN is pain drugs which he is now addicted. He begs every day to get off the meds and find an answer. I got him an appointment at the Cleveland Heart Clinic in OHIO in 2 weeks last opportunity I know of. He can only lay on one side with out the pain and every doctor I called will not offer any option except pain medicine which is going to ruin his family or kill him. The wires were removed 3 years ago. One surgeon stated wow your doctor put you back together in a hurry didn't he..... but offered nothing more but pain meds. He desperately needs help but I don't know what to do any suggestions from anyone who has experienced this kind of pain. Thanks to all and God bless
Chronic Sternum Pain 7 years after CABG, Knoxville, Tennessee, USA, February 5, 2012

• I had Davinci's robotic heart bypass using the mammary artery. Would like to hear anyone having problems with this type of bypass. I also have a stent Xience from Abbott and am very fatigued. I walk every day but have no energy. It sounds like they are having some success with this drug-coated stent but am worried. I am 67 and also experience low grade fevers. My BP is high 150/90 and have tried at least 5 different meds. to get it down and nothing helps. Now I have two valves leaking, the mitral and aortic. I am so tired of problems. Don't know what tests to have next. Had a echo showing the valve problems and my heart is somewhat enlarged.
Elizabeth, Pennsylvania, USA, January 11, 2012

• Kathy in Kansas and Bev in Michigan -- it is very frustrating to go through bypass surgery and then have the bypasses close up. Sometimes the fix is sometimes placing a stent in the bypass graft; sometimes in the original artery that was bypassed. President Clinton had this happen to him as well -- he received two stents in a native artery that was originally bypassed because his bypasses closed up. Coronary artery disease is a chronic disease. Neither bypass surgery nor stenting/angioplasty actually cure the disease: they can only relieve the immediate problem. One can only do one's best to reduce all risk factors and slow/stop the progression of the disease. These include stopping smoking (no more cigars for President Clinton), changing diet (since his stenting, he's become a vegan), exercising, etc. Also being very diligent about prescription meds to lower cholesterol, blood pressure, etc. However, genetics also play a significant role and that's not something under our control (not yet anyway!).
Angioplasty.Org Staff, Angioplasty.Org, January 4, 2011

• I'm 52 female had quadruple bypass 12 2010 and have had 6 stents since then frustrated don't understand afraid of having chest pain or heart attack has anyone else had this oh and i have CAD a lot of upper back pain.
Kathy H, Wichita, Kansas, USA, December 23, 2011

• My father had 4 bypass and 1 valve done four months ago and we just found that 3 out of the 4 bypass are blocked again. So soon? Has anyone heard of this and if so, were can I find more information. The doctors are not giving us any options. The 4th bypass is is clear. Help any and everyone. Thx
Bev, Michigan, USA, December 16, 2011

• Kreece in West Virginia -- This topic is about patients having problems after coronary artery bypass surgery. We do host a topic on "Financial Assistance for Prescription Drugs" -- don't know if there's info there for your dad's situation, but possibly your family doctor canhelp guide you through the complicated morass of insurance and Medicare coverage. Hope you find help.
Angioplasty.Org Staff, Angioplasty.Org, December 16, 2011

• My dad needs insulin shots for diabetes. Even with Medicare (80%), and supplemental Blue Cross/Blue Shield (20%), they will not cover it. It will cost him $300 a month for it. He does not have the money, so he is not doing the injection shots. How can he get help if neither insurance will cover it?
Kreece, Charleston, West Virginia, USA, December 16, 2011

• 53 Male - Had heart attack and single bypass of LIMA to LAD beating heart method Oct. 2010. 6 week check up everything OK. Stress test for work medical Jan 2011 showed abnormalities. Referred back to cardiologist who done a nuclear stress test, angiogram & echo-cardiogram. Graft has atrophied (wilted). They think it may be caused by a technical issue? Saw surgeon who is going to redone bypass using RIMA. No real symptoms that anything was wrong apart from an occasional ache in left arm, which I have been told is angina. 2nd time luck I hope
Rick, Lancashire, UK, July 22, 2011

• how much time later we can start atorvastatin after cabg?
Nitya, Raipur, India, July 20, 2011

• Paula M from Liverpool -- Does your dad think this is the same pain he used to have? Bypass grafts are usually good (medical term: patent) for 5-10 years. There is the possibility that one or more of the grafts have closed up (this happens more often with the saphenous vein grafts) but only his cardiologist can tell you this. For example, this happened to former U.S. President Bil Clinton last year, although it was six years since his bypass surgery. He was treated with two stents and went back to work two days later..
Angioplasty.Org Staff, Angioplasty.Org, May 1, 2011

• my father is 70yrs old he had coronary artery bypass graft in 2009, he has been complaining today with chest pain is this angina back?
Paula M, Liverpool, England , May 1, 2011

• I had a 4x bypass in September of 2002 at age 46, it was done at Stony Brook Hospital in NY. My surgeon was Thomas Bilfinger, a highly regarded heart and lung surgeon, i would highly recommend him for a patient in need. I have made a 100% recovery thanks to Stony Brook H. and also my extreme drive to get well after the operation, i bicycle 60+ miles, do 5k's, and lift weights. I also changed my diet to lower cholesterol levels. I was told by my Cardiologist that the operation only does 50% the other 50% needs to be done by me doing exercise, diet, etc. people need to take responsibility for themselves too, it's a team effort.My only recent problem seems to be with staph infections, i have had 2 in the last few years however staph infections seems to affect cardiac patients more so i assume i'll have to live with it and hope for the best.
Frederick, Mastic Beach, New York, USA, April 24, 2011

• I'm 50 and had a quadruple bypass June 2010 then rushed in to find out all arteries from bypass collapsed. The LCX (left circumflex artery) received 2 stents leaving EF (Ejection Fraction) @40%. Seen 3 cardiologists, 2 Surgeons and no one can explain. I've been advised by all that collaterals are all over my heart and suggested not to redo bypass for fear the arteries will collapse again. Still working too, energy very low. What is life expectancy or does anyone have any other suggestions of how to proceed. Extremely scared!
Cacicedo, Royal Oak, Michigan, USA, January 15, 2011

• Hi I am enquiring on behalf of my father he is 68 yrs old and has had CABG almost 9 weeks ago he is complaining of pain in his left arm which he mentioned at his follow up appointment, and was told this will not be angina? he thinks it is he has taken the GTN spray and also tried patches this does not seem to work should he go back to his cardiologist? he also suffers from osteoporosis so he is very confused he has very limited movement and cannot fully raise his arms? please can you advise?
PM, Liverpool, United Kingdom, February 10, 2010

• My husband who is 61 had CABG x3 May 2009,he developed bronchitis and broke 3 sternal wires from coughing. He has been is and out hospitals several times. Oct 2009,he had xyphoid process removed. We thought that would help with the unbearable pain.He is on morphine and percocet and that doesn't relieve pain either. He is scheduled for Feb 2010 to remove all 7 wires completely. He also has a 4.4 aneursym. The 3 wires that are broken are at the bottom of his rib cage, if he pushes they together, the pain stops. If surgeon takes out all the wires, won't that put more pressure on the rib cage? Surgeon said that his ribs would never heal together completely, just be cartlidge like in your nose. Surgeon said that one wire is directly over one of the grafts. My husband also has lupus and anemia. Bleeds easily and doesn't clot fast.
MS, New York, USA, January 14, 2010

• My Father (63 years) had CABG 3 years back. He recovered well and took his normal duty immediately after 3 month after the operation. He never had any breathing issue and No chest pain. The only issue he is complaining is that he is feeling some stiffness or feeling like lifting weight over the operated area. He doesn't feeling the same when he was laying down. Doctors are neither listening to this complaint nor saying no issue. Can anyone have similar experience and any suggestion to come of this?
Post CABG Issues, Chennai, India, November 8, 2010


• My husband, age 73, had a 4x CABG about 5 yrs ago. He has type 2 diabetes, is not on insulin. He complains of spells where he becomes extremely cold, lasting approximately 30 minutes. Could this be related to the CABG? Has it to do with the diabetes, or possibly the combination of CABG and diabetes? Other than that he is in excellent health and exercises regularly.
Ellen, Boone County, Kentucky, USA, October 30, 2009

• What would cause a triple bypass surgery to fail less than a yr. after surgery. Can or is it safe to have it repeated?
Lynn D., Florence, Kentucky, USA, August 5, 2009

• got cabbage (CABG) done 3 years ago right leg gives me a lot of jiff any help out there and brain problems since bypass are very worrying. doctor says bypass causes brain and have to live with it. is there help out there as me going crazie thanks pat
Patrick Hanley, Limerick City, Ireland, July 24, 2009

• A general comment -- this is a Patient Forum and not an "Ask The Doctor" service, so we recommend to all patients with problems that they discuss these problems with their cardiologist or in this case, their surgeon. If you want to, definitely get a second opinion when you have not gotten an answer that satisfies you. You will need your records and almost definitely your angiograms, both pre and post surgery, if possible. These are complex matters and we do not and cannot give medical advice. We also urge our readers to chime in with any assistance. We can say that bypass grafts sometimes close up for various reasons -- it is possible then to place a balloon and stent in the graft. For specific questions about this area, consult an interventional cardiologist.
Angioplasty.Org Staff, Angioplasty.Org, November 2, 2008

• I am writing about a friend/She is about 54 with history of insulin/diabetes. She had open heart surgery 5 bypasses a year ago/about two months ago she started having problems such as she noticed prior to open heart surgery/in chest, sob, etc. She had tests done, and cardiologist and surgeon/found at least one vein-artery that was all curved, in circles and something he had never seen before. Following tests showed no blood flow coming out of that one and bottom line is there are 3 that need to be bypassed, and they recommend open heart surgery again. 1-question: what would cause that type of problem with the weird, shape etc /as we are thinking the graft wasn't done right/right length etc by surgeon? 2/ is there a less intrusive method? 3/ we suggest a second opinion? any thoughts please? thanks much.
rmames, Wisconsin, USA, October 20, 2008

• hi, i am fatma! my husband is 52 years old and he is a postoperative CABG, his operation was done last august 11,08. I just wonder why on his 4weeks of post operative CABG he is still in pain such as painful sternal clicking and every time he will get in and get out from the bed he feel painful click on his sternum, is it normal or not? and if ever for how many weeks or months before he completely recover, if someone knows or experienced about this case of my husband please help me to know, cause i am really worried. I am trying to get an answer for this case of my husband and hope to hear from this site the answer to my question, thanks very much!
Fatma, Cairo, Egypt, October 9, 2008

• Could it be possible that some type of nerve damage was done when I had my bypass surgery in 2004? About 4 months after my surgery I started feeling cold that I feel like I am sitting in a tub of ice water. I have to stay in bed 95% of the time with 3-4 blanket on me and my room temperature at 85-90 degrees. I only leave the house to go to the doctor. I have been to 3 cardiologist, 2 endocrinologist, a rheumatologist and see my internal medicine doctor on a regular basis. These doctors all say they have never had a patient like me. I have had all kinds of tests....that show nothing. They have just gave up on me. I was wondering if some nerve could have been damaged or cut that would cause me to be cold. I am so miserable I do not want to live the rest of my like like this. What type of specialist would you suggest I see?
Don R., Texas, USA, June 15, 2008

• Ray -- Maybe we're going to have to start a new topic on EDTA, a.k.a. chelation therapy, Artery Clearance Therapy (ACT) etc. since we're getting a number of queries. As far as we know, there are no randomized clinical trials or peer-reviewed articles in major cardiology journals showing efficacy of these therapies. However, an NIH-sponsored study was begun back in 2002 and is still recruiting. The Trial to Assess Chelation Therapy (TACT) won't be finished recruiting until 2009 (they have 163 centers). We look forward to the results, but as of now, there's no real data to show this therapy is valid. The danger is that patients will self-treat (and spend money on the drugs) and avoid the proven therapies.

As for Ascorsine-9, we don't know much about it, except that it seems to be a formulation of essential vitamins and some other ingredients. But we did note on a supplier's website the following: "WARNINGS: Anyone taking anti-coagulation drugs should not take this product", so we would be very wary of Ascorsine-9 for heart patients who may well be taking anti-coagulation or anti-platelet drugs. Talk to your cardiologist about this.
Angioplasty.Org Staff, Angioplasty.Org, February 28, 2008

• May I have comments on the use of artery cleaners EDTA ethylenediaminetetraacetic acid and/or Ascorsine-9 nine months after double bypass surgery.
Ray G., Georgia, USA, February 10, 2008

• My brother had 4x CABG 1 year ago. He had a very hard time healing and his angina is back at 6 months from smoking (we think) and had an angiogram at 6 months that was clean. Of course, he took it from that that he could keep smoking. As it turns out, we just find out he has not been taking an aspirin a day or his blood pressure meds. His blood pressure is good though at 120/70. Surprising but true. I am very concerned that the longer he doesn't take the prescribed drugs, the faster he will need additional treatment. He really thinks that the meds were making him worse because now his BP is good! However he is taking Protonix and 4 tums a day to try to help the burning under his sternum. The doctor just keeps saying, your pictures at 6 months were clean, so you are in good shape. The dr is ignoring the burning under the sternum - knowing he has stopped meds. HELP!! Any suggestions? He is only 50 years old and has lost his desire to keep fighting.
K.R., New York, USA, October 15, 2007

• Russana -- look up our Forum Topic on EECP for more info.
Name, State, USA, October 13, 2007

• Can someone please help. My father who is 69 years old had a bypass 6 months ago and has been in an out of hospital since the operation, which has seen no positive result. He is currently in hospital and having ongoing angina attacks, up to 3 per day, often when he is asleep. I have read about EECP on the internet and am very interested in this treatment for him. We live in Sydney Australia, does anyone know whether this treatment in offered in Australia?
Russana, Sydney, Australia, October 10, 2007

• Hi, i am a 52 year old male and weigh 128 kg.have had 2 stents, a by-pass in 1995 and 2006. I will be contacting my cardiologist monday next week for an appointment as i am experiencing swelling of my feet which never happened before, heart beating irregular and wonder if i am nor in the early stages of heart failure as the swelling is excessive. I do cardio exercise each day for 1 hour and drink 2 litres of water whilst exercising... Is the fluid intake to rapid in that period...? I am a very active person working my 14 hours per day up and down and wonder if the fact that i am so active, also be the cause. Would appreciate your comment.
Johan Stapelberg, Brooklyn Holdings, South Africa, August 25, 2007

• Gerald -- you certainly are an EECP evangelist (by the way, Angioplasty.Org's Forum has a topic devoted to EECP). And the treatment has been shown to help some patients who still experience chest pain if it is not relieved by drugs, angioplasty or surgery. And this is not a small number: the recent COURAGE trial showed that 1 in 4 patients still had chest pain after 5 years. The general theory that vascular disease and blockages are at least partially a result of endothelial dysfunction is pretty well accepted. The big question is what causes this and how best to treat it. You're correct in saying that interventional procedures don't improve this dysfunction systemically. We (and the physicians who pioneered this field) always say, angioplasty is a mechanical solution to a biological problem. One of the positive aspects of the COURAGE trial was that modern medical therapy (statins, beta-blockers, etc.) seemed to have a definite systemic effect and low-risk stable patients did very well without any intervention. There is much research going on into how best to restore endothelial function. EECP has had several clinical trials which have shown some benefit in certain patients -- and you and your friend are definitely in that category. But overall, the trials have not shown EECP to be "the cure" we're all waiting for. Which is not to say it's not valuable and most definitely under-utilized. The Minneapolis Heart Institute at Abbott Northwestern has a whole program to treat patients who have not responded to the mainstream therapies. Called OPTIMIST, it offers a range of solutions, one of which is EECP.
Angioplasty.Org Staff, Angioplasty.Org, May 4, 2007

• John S, patient, Brisbane, Australia: John, many of your questions and concerns can be answered by reading my post to Jack D. but let me personally address these: "You mention some going 3-5 years without need for re-treatment. Are these people you know or have you just been told this?" I was told this by technicians and cardiologists at the two different provider sites I attended to receive my 4 x 35 hour courses of treatment. One EECP patient Tom is now about 87 years old. I made his acquaintance on a financial message board. He is a highly intelligent man and is in very good health today, probably in BETTER HEALTH today than he was 10-15 years ago when he was receiving repeat angioplasties and major CABG procedures. He swims and works out almost daily at their local YMCA's gym and pool. He will easily swim the length of their pool underwater regularly. We email one another weekly, often exchanging information which helps us better understand all of EECP's mechanisms of action which, by the way, are still highly misunderstood by many/most cardiologists. I am proud to regard Tom as a good friend although we have never personally met.

"Also I am concerned that in some instances EECP does not work - why is this do you think?" A very fine cardiologist once explained to me that he believed those 20-25% patients who have not responded to 35 hours of EECP treatment do so simply because they require many more hours. The differences between individual patients are just too great to expect them all to respond the same. Some patients require 45 hours, 60 hours or even 75 hours. Treated in this manner, you will see over 95% of the patients regularly improve by one or more class. Patients who receive EECP for Class III or IV angina caused by ischemic heart disease will almost always have a pre-existing state of endothelial dysfunction and a loss of vascular homeostasis. In this disease state (which cardiologists seem to ignore), the vascular system has become inflamed and constricted. This seems to be a precursor to full blown atherosclerosis which will then accelerate the progression of ischemic cardiovascular disease. In this inflamed and constricted state, vascular lesions will develop throughout the entire vascular tree. As the body attempts to heal these vascular lesions they may become covered with something very similar to a scab or a sore on, for example, your arm or leg. In endothelial dysfunction, the vascular wall, being very constricted, makes those lesions more susceptible to rupture. Patients in this condition are often rushed to the hospital and DESed with off label use of a $30,000.00 stent. Their symptoms may be quickly improved but the underlying endothelial dysfunction which caused the inflammation, the constriction, the lesions and the ruptured lesions will remain a threat because, to my knowledge, invasive procedures will do nothing to treat the underlying endothelial dysfunction and the loss of vascular homeostasis. But now get this! EECP treatment will not only improve the the symptoms of angina and ischemic heart disease but it has also been shown in multiple studies to REVERSE ENDOTHELIAL DYSFUNCTION and to the degree that it does this IT WILL ALSO RESTORE VASCULAR HOMEOSTASIS. This means that EECP may decrease pro-inflammatory cytokines while increasing anti-inflammatory cytokines which means less vascular inflammation, less constriction and a more stable vascular system. Following this cascade of vascular events, we can by logical extension, expect then, to see FEWER ruptured lesions. With FEWER lesions rupturing, we should expect to see FEWER new blockages, FEWER embolisms, FEWER strokes, FEWER MIs, FEWER hospitalizations and yes, even a REDUCED mortality rate. All of this should proceed from EECP's effect of REVERSING ENDOTHELIAL DYSFUNCTION. And again, this is something that invasive procedures, by themselves cannot do. If you still have questions, I would be happy to help you. Please email me at [Note: posting has been edited for length]
Gerald Oros, Collinsville IL, May 3, 2007

• Sorry I should have said 14 stents, ex-smoker, quadruple bypass (she quit 1 year ago) but that does not make her an official "non-smoker" yet. I believe you have to be clean for a while before you get that label.
Jack D., New York, USA, May 1, 2007

• Jack D: Geeze Jack! Don't you think it's high time you and your wife stood your ground and made some some of these decisions yourselves? You're going to get nothing but more of the same from your doctor. So what other treatment options does your wife have? Your doctor, if he is responsible, should have already told you. There is the FDA approved, Medicare reimbursed, NON-INVASIVE treatment option called Enhanced External Counterpulsation also referred to as EECP or ECP.

You can learn everything you need to know about this in the next 15 minutes by going to and clicking on the DVD for patients to immediately view what, how and why this therapy is so safe and effective for relieving angina. At this late stage of treatment, it was very, very wrong of your cardiologist to not inform your wife of this option but instead -- continue to inflict more and more invasive procedures upon her which obviously are not helping her but which is making him very, very wealthy. But don't be too hard on your doctor because as I estimate it more than 95% of the other invasive cardiologi$t$ are doing the $ame thing. Now, don't misunderstand me, most of these invasive procedures produce good results right away and the patients will receive good symptomatic relief. But no one should be subjected to 14 stents, a CABG and then still want to do another damned angiogram!!! Jack, believe me please! Sit down with your wife and watch the DVD called "Straight From the Heart" ASAP! If, after watching that film and you feel that your wife wants to try it. Ask your cardiologist to arrange for the 7 or the 3 1/2 week course of treatment. If he tries to discourage you from trying it, get another doctor! You see the cost for a course of EECP treatment, more often than not, runs less than the sales tax for a single bypass surgery. Prescribing EECP is not as profitable as sawing open a patient's chest. I'm sure you both get the picture!

If, after viewing the film, you still have questions, I would be happy to help you. Please email me at BTW, I am an angina patient with ischemic heart disease. I had my first course of EECP 4 years ago and the results were so good I chose to have it repeated for the next 3 years. I will take my 5th course of treatment this Summer ---- so I think I know a little something about EECP and I can give you some tips of how to get even better results from it if you're interested.
Gerald Oros, Collinsville, Illinois, USA, May 1, 2007

• Gerald O., Illinois. You mention having had EECP, as an alternative to CABG. I am at the stage of considering my options and this treatment a possibility. Can you tell us your condition (angina, number of blockages and symptoms) which led to the treatment and how soon after starting you saw some improvement? You mention some going 3-5 years without need for re-treatment. Are these people you know or have you just been told this? Also I am concerned that in some instances EECP does not work - why is this do you think? Best Regards.
John S., patient, Brisbane, Australia, May 1, 2007

• To Jack D. in NY: several months after just one stent, I observed pain whenever inhaling a cigarette. Ok, the solution was a no brainer, I quit smoking and the pain went away. Done. You write that your wife had 14 stents, quadruple bypass, but she continues to smoke and she is (even otherwise) resisting her doctor? Hello? Please show your wife all the warnings on those cigarette packages, they are serious.
Tom, Encinitas, California, USA, April 30, 2007

• My wife, 43 yrs old, diabetic, smoker had a quadruple bypass 5 mos ago. This was after 14 stents to the RCA in an 18 mos period and during that time span an MI from a clot. 3 mos after the CABG, her angina pains slowly returned and at 5 mos they are in full swing. She gets pressure with exertion and without. When her blood sugars are low she gets intense chest pressure as well as a burning pain directly under her sternum. The Dr says an angiogram is indicated. She is resisting. Anyone else had these issues?
Jack D., New York, USA, April 29, 2007

• I would suggest looking into the possibility of having a blood sugar problem and not knowing about it. My wife, age 43, after experiencing severe unstable angina, was given 4 DES in Nov. 05. She continued having angina, although less severe, and was very dissatisfied with the doctors telling her that her case was so exceptional that they could not explain it, only stating that she may be having coronary artery spasms. Since than she has had 5 heart caths done and 4 more stents inserted inside of the ordinal stents because of restenosis and also had a blood clot form that required a balloon to clear her stent that resulted in the stent becoming fractured. Her family doctor decided to test her for insulin resistance and we were quite surprised to learn that, yes, she does have this syndrome. It is also known as Metabolic Syndrome or Syndrome X. It has the tendencies for forming clots and causing plaque to build up in the coronary arteries. We recommend the book "Syndrome X The silent killer". We have just started her diet change so we cannot report any success yet but are very hopeful that this is the cause of her continuing problems. Good luck and we hope that this may give you another avenue to explore.
Paul S., Michigan, USA, February 15, 2007

• Pam, Lafayette, Louisiana Pam, there is a very safe, non-invasive procedure which is FDA approved for the treatment of Class III and IV angina pain. Medicare will reimburse for it and it is covered by most, but not all, insurance companies. It is presently reserved in most cases for patients who fail to respond properly to the invasive surgeries and angioplasties/stents. The name of this treatment is Enhanced External Counterpulsation or EECP and/or ECP. If you will go to and watch their video tape, you will learn how and why it works. It does require some commitment from the patient as they have to receive this treatment 5 hours a day for 7 weeks. The treatment is comfortable enough to tolerate and has a success rate of about 80% with 35 hours treatment. I have received this treatment for my shortness of breath and angina pain with good results but because my arthritic knees inhibit my ability to exercise, my symptoms begin to return after about a year. So, I have chosen to get the treatment yearly and have done so for the past 4 years. Most patients, however, are able to go 3-5 years or more with just one course of treatment. Despite its success record, physicians are not too quick to recommend it because at the present rate of reimbursement (shamefully low), doctors find that is is not very profitable and therefore, quite understandably, prefer to keep using invasive procedures. The cost of a course of EECP is often less than the sales tax for a single bypass surgery.... Stent placements run 5-6 times the cost of a course of EECP.... If he wants the EECP treatment, he's going to have ask for it and then not be dissuaded if the doctors then try to change his mind. He must be adamant yet respectful. If he can do this most doctors will be glad to prescribe the treatment for him.
Gerald O., Illinois, USA, February 14, 2007

• My brother is 49 years old and has had triple bypass about 8 months ago. He has seen very little improvement. Still very short of breath and takes nitro several times a day. The doctors are just beginning to figure out what's going on. Any similar cases out there?
Pam, Lafayette, Louisiana, USA, February 5, 2007

• J Norman-- Looks like you have been though an ordeal... I am a clinical educator in a cath lab and I hope I can help. It really is not quantifiable, your prognosis, from your story. You need to take into account your symptoms and how often, how severe, etc. Regardless of the number of blocked arteries, it is the heart muscles response and amount of damage that is the important factor. Do you know the state of your heart muscle (this can normally be diagnosed by a heart scan or during cath). If your heart muscle is reasonable, then you need to continue with your life, taking one step at a time, always being aware of your symptoms and never ever stressing yourself physically. However, you need to stay positive and mentally active. Your physician was perhaps slightly inaccurate to tell you this was worse than cancer and I feel you have been given inadequate information. You need to know what all this means in real terms and how it will affect your life? There are new advances in cardiology all the time, pharmacological and medical interventions such as cath lab things and you have the right to be know if these will apply to you. I hope I have helped ...and not confused you. You should know that I have seen many patients in your position and they have developed a good relationship with their cardiologist and have learned to live within their means ....and enjoy it!!
Andrina, Prince Sultan Cardiac Centre, Riyadh, Saudi Arabia, February 10, 2002

• 58 Female -- had triple bypass Oct 18, 2001. All attending physicians stated my surgery was a success and I went home in 2 days. On Jan 18, 2002 I experienced severe chest pain and went to the emergency room. The ER doctor conferred with my cardiologist and decided I should undergo a cardiac cath to see what was going on. On Jan 19 after the procedure my cardiologist reported to my family and I that 1 graft has completely blown, graft 2 had 90% blockage in which he placed a stent, graft 3 had approx. 95% blockage and a balloon procedure was done. It was explained to my family and I that my arteriosclerosis was so severe that it caused this all to occur (in 3 months time) and that my prognosis was very poor. He even stated that it was worse than that of cancer. My physician has left us with no hope and no options to explore. I am taking it upon myself to find other avenues of treatment. If anyone has experienced this and has any advice or encouragement let me know.
posted by J. Norman, Loudon, Tennessee, USA, January 20, 2002

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