Small heart vessels
Symptoms despite clear large vessels.
Small heart vessels and EECP in brief.
Even when the large coronary arteries look normal, symptoms can arise from disorders of the smallest blood vessels, also called microangiopathy. EECP Cardio Pulse addresses this possible physical cause.
How you may notice a disorder of the small heart vessels.
- Pressure or burning in the chest, often lasting longer
- Symptoms on exertion, but also at rest or under stress
- Cardiac catheter or CT: no relevant narrowing
- Breathlessness and exhaustion that no one can explain
- More common in women during and after the menopause
- The feeling of not being taken seriously
What happens in a disorder of the small heart vessels.
Sometimes the large coronary arteries are clear, and yet symptoms persist. The cause can be disorders of the smallest vessels, known as microvascular dysfunction. These tiny vessels cannot be treated with a catheter or stent.
Where EECP starts with small heart vessels.
The smallest vessels of the heart are not visible on catheterisation. Even so, they can explain symptoms, even when the large vessels are clear. Treatment relies primarily on medication. It widens the vessels and relieves the heart. If symptoms remain, EECP Cardio Pulse can be a complementary option. It acts on the vessel lining that controls the small vessels.
How EECP can help with microvascular dysfunction.
EECP Cardio Pulse acts right down to the smallest vessels and on the inner vessel lining (endothelium), which controls their dilation. Precisely where procedures cannot reach, EECP can improve the regulation of blood flow.
Who EECP may be an option for with small heart vessels.
Angina without a narrowing
The catheter was normal, but the symptoms are real. The diagnosis is then often microvascular angina, also called INOCA in medical terms.
Symptoms despite medication
The previous medication does not work well enough or is not tolerated.
Other causes ruled out
Heart, lungs and stomach have been examined. The small vessels remain as the explanation.
What speaks for EECP in small heart vessels.
Acts down to the smallest vessels
Works where stent and catheter cannot reach
Aim: better regulation of blood flow
Lasting effect of EECP therapy for small heart vessels.
After the course no further treatment is needed. If the smallest vessels respond to demand again, that can be retained. How long, varies from person to person. A course is repeated if needed.
What EECP does not do for small heart vessels.
First, a narrowing of the large vessels must be ruled out. Only then is the diagnosis of the small vessels established. Our heart specialists take care of this assessment, and it comes first. EECP Cardio Pulse then complements the medical treatment and does not replace it.
Using everything, leaving nothing out.
Our philosophy: use every option in cardiology – including the body's own natural powers. EECP Cardio Pulse sets targeted flow stimuli and supports the vascular system's capacity to adapt. Entirely without a procedure, complementing conventional cardiology. As much as necessary, as gentle as possible.
Your path with EECP Cardio Pulse.
- 01
Cardio Check-Up
cardiac diagnostics.
- 02
First session
One hour lying down.
- 03
Series
35 sessions, one hour each.
- 04
Final check-up
The check-up.
View related research
A documented case from the Mayo Clinic describes a young woman with pronounced coronary endothelial dysfunction without narrowing of the large vessels, whose symptoms decreased markedly and lastingly after a 35-hour EECP course. The approach is supported by the studies on endothelial function under EECP.
Bonetti PO, Gadasalli SN, Lerman A, Barsness GW. Successful treatment of symptomatic coronary endothelial dysfunction with enhanced external counterpulsation. Mayo Clin Proc. 2004;79(5):690–692. PMID 15132416
Questions about EECP for microvascular dysfunction.
My coronary arteries are clear. Why do I still have symptoms?
The cause then lies in the smallest vessels, which are not visible in the catheter. If they do not widen properly or go into spasm, the heart muscle receives too little blood under exertion. The large vessels are clear at the same time. These tiny vessels cannot be treated with a catheter or stent.
How is microvascular dysfunction diagnosed?
Usually by exclusion: catheter or cardiac CT show no relevant narrowing, yet the symptoms remain. Specialised centres can measure the function of the small vessels directly during catheterisation. Bring any existing findings with you. We assess them in the Cardio Check-Up.
How does EECP reach these small vessels?
Through the vessel lining, which controls their widening. The rhythmic pressure increases the flow right into the finest branches, and the endothelium again produces more vasodilating messengers. In this way the regulation of blood flow can improve.
Is there data on this diagnosis?
In an observational study with 101 patients with angina without a narrowing, the severity of angina and the weekly attacks fell markedly after a course of EECP, while walking distance and exercise capacity rose. A documented case from the Mayo Clinic describes a marked and lasting improvement. Controlled studies are still pending.
Why are women more often affected?
The reasons are not fully understood. Hormonal changes during and after the menopause probably play a role, as do differences in vascular structure. What is certain is that the symptoms are physical and deserve a serious assessment.
Is EECP an option if the symptoms also occur at rest?
Symptoms at rest do occur in disorders of the small vessels, for example due to vessel spasms. They must first be assessed by a cardiologist. After that, EECP can be used as a complement. The study data relate mainly to symptoms on exertion.
General information, not a promise of cure. Whether EECP is suitable for you is something we clarify after a cardiac examination.
Just give us a call.
We answer your questions and arrange an appointment together.
Private service under the GOÄ fee schedule: about 100 euros per session.