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Enhanced External Counterpulsation


  • Enhanced external counterpulsation, or EECP, is a nonsurgical procedure used to increase blood flow to the heart. You may have EECP therapy if you have decreased blood flow to your heart caused by a blood vessel blockage. Decreased blood flow can occur if you have coronary artery disease, acute coronary syndrome, or congestive heart failure. You may also have a blockage from an acute myocardial infarction (heart attack). When your heart does not get enough blood and oxygen, you may have angina (chest pain). If your heart is not pumping well, less oxygen may travel through your body. You may feel more tired than usual and you may have trouble breathing well. Decreased blood flow can make it hard for you to do your normal daily activities.
  • You may need EECP therapy if other treatments did not work to treat your heart condition. This includes medicines and heart surgery. During EECP therapy, large cuffs are placed on the lower and upper parts of your legs. The cuffs are filled with air starting with your lower legs and moving up to your upper legs. A computer uses your heartbeat to tell the cuffs when to fill with air and when to release the air. As the cuffs fill with air and release the air, blood is forced back to the heart.
  • EECP therapy is normally done one hour per day, five days per week, for seven weeks. Caregivers may suggest EECP therapy beyond the initial 35 sessions if your condition has not improved. Having EECP therapy may help decrease the amount of heart medicine you need. EECP can also reduce inflammation in your heart and the pain caused by some heart conditions. Inflammation is your body's response to an injury or illness which, overtime, can lead to tissue damage. With EECP therapy, your heart may get more blood back from your body. Your heart may pump better and move more blood and oxygen throughout your body. EECP therapy may help decrease your chest pain and you may have more energy.


Take your medicine as directed.

Call your primary healthcare provider if you think your medicine is not helping or if you have side effects. Tell him if you are allergic to any medicine. Keep a list of the medicines, vitamins, and herbs you take. Include the amounts, and when and why you take them. Bring the list or the pill bottles to follow-up visits. Carry your medicine list with you in case of an emergency.

Ask for information about where and when to go for follow-up visits:

For continuing care, treatments, or home services, ask for more information.

Decrease your stress:

Learn ways to manage stress. Deep breathing, meditation, and listening to music may help you cope with stressful events. Talk to your caregiver about other ways to manage stress.

Eat a healthy diet:

Healthy foods may help you have more energy and heal faster. You may need to eat more fruits, vegetables, whole-grain breads, low-fat dairy products, beans, lean meat, and fish. You may also need to eat fewer foods that have a lot of fat, salt, or sugar. Ask your caregiver if you need to be on a special diet.


Exercise makes the heart stronger, lowers blood pressure, and helps keep you healthy. Begin to exercise slowly and do more as you get stronger. Talk with your primary healthcare provider before you start an exercise program.

Manage your other medical conditions:

You can help your heart work better by managing medical conditions you may have. For example, diabetes (high blood sugar) or high cholesterol (fat in the blood) can make your heart problems worse. Ask your caregiver how you can manage your health problems.

Quit smoking:

If you smoke, it is never too late to quit. Smoking harms your body in many ways. You are more likely to have heart disease, lung disease, cancer, and other health problems if you smoke. Quitting smoking will improve your health and the health of those around you. Ask your caregiver for more information about how to stop smoking if you are having trouble quitting.


  • The tingling in your legs continues or gets worse after your EECP treatments are done.
  • You have new or increased leg bruising or soreness or tenderness (pain when touched) in your legs.
  • You have new or increased swelling in your ankles, legs, or throughout your body.
  • You have questions about your condition or EECP treatments.


  • You have signs or symptoms of a heart attack:
    • Chest pain or discomfort that spreads to your arms, jaw, or back. You may also have chest pain that is strong, sudden, or does not go away.
    • New, sudden back pain.
    • Nausea (feeling sick to your stomach).
    • Trouble breathing.
    • Sweating.
    • Lips or nailbeds that turn blue or white in color.
    • This is an emergency. Call 911 or 0 (operator) for an ambulance to get to the nearest hospital or clinic. Do not drive yourself!
  • You get dizzy and faint (pass out).

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

Learn more about Enhanced External Counterpulsation (Aftercare Instructions)

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