Abstract

Compression therapy 'Double focal compression bandaging' in patient with cardiac failure. Can we use compression therapy in these patients?

Author(s): Carlos Sanchez Fernandez de la Vega

Cardiac failure is usually listed as a contraindication for compression therapy, due to the improvement in preload caused by the displacement of volume of blood to the heart. A potential impact of compression therapy on the cardiac or heart function has rarely been studied. Can we use it, in patients with NYAH class I, II, or III heart failure? Of course, compression in legs is contraindicated in patients with NYAH class IV: “Patients with heart disease resulting in the inability to move on any physical activity without discomfort. Symptoms of Cardiac failure or the anginal syndrome may be present even at rest. If any physical activity is undertaken, discomfort is improved” (NYAH classification) (1). We used compression therapy for years, as only treatment in patients with vascular ulcers (legs). Some of them with Cardiac disease, and one of my fears was that the compression could worsen their symptoms. They were subject to special follow-up to detect signs and symptoms of cardiac decompensation, in which case, we would remove the bandaging. However, what we observed was that they improved regard to cardiac function (there was not cardiac decompensation) and their quality of life. There are some papers about this clinical fact (2). We needed find an explanation for this improvement, and this one could be in physiological secretion natriuretic peptides (Fig 1).