DEAR DR. DONOHUE: I am 82 years old and had a heart artery bypass surgery 10 years ago. Recently I have had chest discomfort while walking. A heart catheterization showed new artery blockages. Among suggested treatment is one that uses a cuff on the legs. The cuff inflates and deflates to get more blood to the heart. Is this new? What is its success rate? – C.E.

ANSWER:
The procedure is enhanced external counterpulsation – EECP. It’s both new and old. It’s a refinement of an older procedure.

A series of inflatable cuffs wraps around the lower body from calves to buttocks. It looks a bit like the bottom half of an astronaut’s space suit.

Between heartbeats, the cuffs inflate in sequence from the lowermost one to the top one. The cue that turns on the inflation comes from a continuously running ECG that switches on cuff inflation and deflation at the proper moment in the heart cycle.

The inflation and deflation of the cuffs act like a pump bringing more blood back to the heart and the heart muscle. The increased flow of blood to the heart nourishes it and encourages the sprouting of new, clog-free blood vessels. It’s the same thing that happens when you water your garden.

The usual treatment calls for hour-long daily sessions five days a week for seven weeks.

Its success rate is in the range of 70 percent. Sometimes, chest pain – angina – returns in six to 12 months. If that happens, the procedure can be repeated. It’s not a strain on the body.

Angina and clogged heart arteries belong to the class of illnesses called coronary artery disease. The new pamphlet on that topic explains in greater detail what’s going on and what can be done for it. Readers can order a copy by writing: Dr. Donohue – No. 101, Box 536475, Orlando, FL 32843-6475. Enclose a check or money order (no cash) for $4.50 U.S./$6.50 Can. with the recipient’s printed name and address. Please allow four weeks for delivery.

DEAR DR. DONOHUE: My doctor told me I have an enlarged heart. He didn’t say what I was supposed to do for it. I do take blood pressure medicine, but other than that I feel fine. Don’t athletes have big hearts? – R.M.

ANSWER:
Professional athletes often have hearts that are slightly larger than nonathletes’ hearts. That enlargement is good. Their exercise causes growth of heart muscle, and their hearts are better able to pump more blood with each heartbeat. Please note that the stress athletes put on their hearts is intermittent.

High blood pressure and some heart valve problems put a constant strain on the heart. It enlarges to cope, but without a respite from the stress, the heart muscle is like a horse that races 24 hours a day. It’s going to give out.

Your high blood pressure is the obvious cause of your enlarged heart. If you don’t have a home blood pressure monitor, get one. Keep a record of your pressures. If they are always up, then you need a medicine change or a dosage change.

In addition, drastically reduce the amount of salt you eat. That does not just mean stop using the saltshaker. It means giving up salty foods — potato chips, pretzels, sauerkraut and most processed meats. Commercial soups often contain a hefty salt load. Read labels.

Get four servings each of fruits and vegetables every day.

Begin an exercise program if your doctor says you are up to it.

DEAR DR. DONOHUE: I am 95 years old. I am 5 feet 3 inches tall and keep my weight around 130 pounds. When my weight drops below 130, I lose energy. I am satisfied with my weight. Should I be? – A.H.

ANSWER:
A.H., anyone who makes it to 95 and stays as active as you are does not have to listen to anybody else. Obviously you have done the right things. Stick with what you’re doing. Let us know in detail what that is.

Dr. Donohue regrets that he is unable to answer individual letters, but he will incorporate them in his column whenever possible. Readers may write him or request an order form of available health newsletters at P.O. Box 536475, Orlando, FL 32853-6475.


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