The most common question that doctors (Cardiologists / Cardiac Surgeons) often get asked is; “Is there any alternative treatment?” Alternative treatments are plenty, but not all are effective or even safe.

Lifestyle modification

Lifestyle changes can help you prevent or slow the progression of coronary artery disease.

  • Stop smoking :
  • Smoking is a major risk factor for coronary artery disease. Nicotine constricts blood vessels and forces your heart to work harder, and carbon monoxide reduces oxygen in your blood and damages the lining of your blood vessels. If you smoke, quitting is one of the best ways to reduce your risk of a heart attack. Any form of tobacco is bad for your heart. So chewing tobacco should also be stopped.

  • Control your blood pressure :
  • Frequent measurements of BP are important. Get your BP measured at least every two years if you are young and have normal BP. You may require more frequent measurements if your blood pressure is higher than normal or you have a history of heart disease. The ideal blood pressure is below 120 systolic and 80 diastolic, as measured in millimetres of mercury (mm Hg). Home measurements by automatic BP monitors (For e.g. OMRON) are pretty accurate and convenient. However do ensure that these machines are calibrated against a mercury BP machine at least once a year.

  • Check your cholesterol :
  • Get your baseline cholesterol test done when you’re in your 20s and at least every five years after. If your test results aren’t within normal ranges, your doctor may recommend more frequent measurements. Most people should aim for an LDL level below 130mg/dL. If you have other risk factors for heart disease, your target LDL should be below 100 mg/dL .

  • Keep diabetes under control:
  • If you have diabetes, tight blood sugar control can help reduce the risk of heart disease.

  • Be Active :
  • Exercise helps you achieve and maintain a healthy weight and control diabetes, elevated cholesterol and high blood pressure — all risk factors for coronary artery disease. With your doctor’s OK, aim for 30 to 60 minutes of physical activity most or all days of the week.

  • Eat healthy foods :
  • A heart-healthy diet, such as the Mediterranean diet, that emphasizes plant-based foods, such as fruits, vegetables, whole grains, legumes and nuts — and is low in saturated fat, cholesterol and sodium — can help you control your weight, blood pressure and cholesterol. Eating one or two servings of fish a week also is beneficial.

  • Maintain a healthy weight :
  • Being overweight increases your risk of coronary artery disease. Losing even just a few kilos can help lower your blood pressure and reduce your risk of coronary artery disease.

  • Manage stress :
  • Reduce stress as much as possible. Practice healthy techniques for managing stress, such as muscle relaxation and deep breathing.

Chelation Therapy

Chelation therapy is a medical treatment commonly used to rid the body of heavy metals, like treating lead or mercury poisoning. Its use in treating heart disease is controversial and questionable.

During chelation treatments, an amino acid called EDTA (ethylenediamine tetraacetic acid) is injected. It binds to heavy metals and minerals and leaves through the urine. People who support the use of chelation therapy for heart disease say EDTA can also remove the calcium deposits that help form dangerous arterial blockages.

Typically, chelation therapy for heart disease requires many infusions over the span of four weeks and costs thousands of rupees, which is not covered by insurance. The FDA, the American Heart Association (AHA), the National Institutes of Health, and the American College of Cardiology, among others, say there’s no proof that chelation therapy helps to treat or prevent heart disease.
According to the AHA, the EDTA used in chelation therapy can lead to serious complications, including kidney failure, low blood pressure, seizures, and difficulty breathing. Chelation therapy has even been associated with several deaths.

Chelation therapy therefore, is not recommended.

EECP (Enhanced External Counter Pulsation)

EECP is a non-surgical, mechanical procedure that can reduce the symptoms of angina pectoris, by increasing coronary blood flow in areas of the heart that lack blood flow.

During EECP, you will be lying on a bed wearing a series of pressure cuffs around your calves, lower thighs and upper thighs. The EECP system will inflate and deflate these cuffs, moving blood from your lower limbs toward the heart. EECP involves a series of 35 one-hour sessions over a period of approximately seven weeks. The one hour treatment sessions with EECP are painless, but due to the natural movement of the pressurized cuffs, chafing and skin irritation can occur. Regular medications are continued throughout the course of treatment.

Benefits for patients might include decrease in chest pain. However, EECP is not recommended for patients who are good candidates for conventional treatment like angioplasty or bypass surgery. Hence I recommend it only to patients who are either high risk for bypass or not amenable to angioplasty.