Microvascular Heart Disease Treatment with EECP
Even when the large arteries look open on angiography, impaired circulation in the heart's small vessels can cause chest pain. EECP is a non-surgical support that can be added to medication in these patients.
- Non-Surgical
- 35 Sessions
- Painless
Briefly
Helps reduce chest pain and fatigue caused by impaired circulation in the heart's small vessels.
It does not replace medication or lifestyle changes; it complements and supports them.
35 sessions: 5 days a week, 60 minutes per session; no needles, no surgery.
Evidence is limited: small controlled studies are promising.
What Happens in the Heart's Small Vessels?
The smallest vessels that feed the heart muscle cannot widen enough when needed. Even without marked narrowing in the large arteries, the heart muscle may not receive enough blood during exertion. For this reason, diagnosis is often delayed.
Small vessels that cannot widen
When small vessels cannot widen on demand, blood flow to the heart muscle does not increase. These vessels are not visible on angiography.
Large vessels that look open
On angiography, the large vessels may look normal or only mildly narrowed. The cause of the symptoms can therefore be overlooked.
Chest pain
Chest pain may occur with exertion or sometimes at rest. It can last a long time, recur and affect daily life.
Hover over or tap the cards: the related area is highlighted in the image.
Shortness of breath
In some patients, chest pain is accompanied by shortness of breath. Climbing stairs or slopes can become difficult.
Fatigue
Tiring easily and reduced exercise capacity are common complaints. Daily tasks and working life may suffer.
Inner vessel lining
Impaired function of the inner vessel lining (endothelium) plays a role in the small vessels' inability to widen. Smoking, diabetes and high blood pressure can impair this function.
What Changes in Circulation with EECP?
The diagram simply shows how EECP supports heart circulation in small vessel disease. The pressure repeated with every heartbeat supports coronary circulation from the outside.
Small vessels that cannot widen
- Blood flow to the heart muscle does not increase with exertion
- Chest pain and shortness of breath
- Angiography may look normal
- Daily activities are restricted
- Uncertainty and recurring pain can increase anxiety
Supported microcirculation
- Coronary circulation is supported while the heart relaxes
- An increase in coronary flow reserve has been reported
- A reduction in chest pain is targeted
- Applied together with medication
- You lie down and rest comfortably during the session
This is a schematic illustration; small vessel circulation is drawn in simplified form.
Outside Support with Every Heartbeat
During treatment you lie down and rest. The device monitors your heart rhythm with an ECG and controls the cuffs accordingly. Each session lasts about one hour.
Cuffs inflate
While the heart relaxes, the cuffs on the calves, thighs and buttocks inflate in sequence: first the calves, then the thighs and buttocks.
Blood moves toward the heart
Blood in the legs is pushed toward the heart and the coronary vessels. The aim is to support flow in the small vessels and the inner vessel lining.
The heart's workload decreases
The pressure is released just before the heart contracts, so the heart pumps more easily. This cycle repeats with every heartbeat.
What does the patient gain?
As the sessions progress, the aim is for chest pain to decrease and exercise capacity to increase. Progress is reviewed with you at follow-up examinations.
Possible Benefits of EECP in Microvascular Heart Disease
The response varies from person to person. The following are findings reported in studies.
Increase in coronary flow reserve
In a controlled study, coronary flow reserve increased after 4 weeks of EECP compared with the control group. The measurement was made with cardiac ultrasound.
Less chest pain
In the same study, the angina class dropped and quality-of-life questionnaire scores improved. The assessment used standard questionnaires.
Support for the inner vessel lining
An analysis of randomized studies reported improvement in the vessel dilation response (FMD). A healthy endothelium is important for small vessels to widen.
Heart function
In the group receiving EECP together with rehabilitation, heart function indicators were found to be better. In this study, rehabilitation was applied to both groups.
A non-surgical option
In small vessel disease, EECP offers a non-surgical support. The decision is made by evaluating your tests together.
Standing and painless
It is applied from the outside with cuffs; you return to daily life after the session. Our healthcare team stays with you throughout the session.
Who Is It Suitable For, and Who Is It Not?
Diagnosis is made with exercise testing, imaging and, if needed, special flow measurements. The decision on EECP is made individually by our cardiologist. Additional tests are requested if necessary.
✓May be suitable for
- Patients diagnosed with microvascular disease whose symptoms continue despite medication
- Patients with normal angiography or mild narrowing who continue to have chest pain
- People with limited exercise capacity who struggle with daily tasks
- Patients who are able to take part in cardiac rehabilitation
- Patients in stable condition who can attend regular follow-up
✕Not suitable for
- Cases where the chest pain is due to a non-cardiac cause
- Severe aortic valve insufficiency
- Aortic aneurysm
- Active deep vein thrombosis or vein inflammation
- Uncontrolled high blood pressure
- severe arrhythmia
- Marked bleeding tendency and pregnancy
How Does the Treatment Process Work?
Blood pressure and pulse are checked before every session. At the end of the course, the results are reviewed with our cardiologist and a follow-up plan is made.
What People Wonder About Microvascular Heart Disease and EECP
My angiography was clean but I have chest pain. Why?
Even when the large vessels are open, impaired circulation in the small vessels can cause chest pain. This is investigated with special tests. Treatment is not planned before the diagnosis is confirmed.
Is a stent placed in microvascular disease?
Stents cannot be placed in small vessels. The basis of treatment is medication, control of risk factors and lifestyle changes such as regular exercise.
Does EECP heal the small vessels?
In small studies, an increase in coronary flow reserve has been reported. There are not yet large studies showing a lasting effect. Results should be interpreted with caution.
Will I keep taking my medications?
Yes. You need to continue your medications as your cardiologist recommends. The decision to change medication is made only by your doctor.
Is the treatment painful?
No. You feel a strong squeezing in the legs as the cuffs inflate; you lie down and rest during the session. If you feel discomfort, the pressure can be adjusted.
When will I feel the effect?
In studies, the assessment was made at the end of the course. The response varies from person to person and is evaluated at the follow-up examination. The results are reviewed with you.
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Contact us for a free preliminary assessment
Could small vessels be the cause of your chest pain? Let us assess, free of charge and together with our cardiology team, whether EECP is suitable for you. You can reach us by phone or WhatsApp.
- Non-Surgical
- Painless
- Physician-Supervised
- Nicosia and Morphou