CARDIO-VASCULAR DISEASES IN AYURVEDA

The Hrudaya, itself being a muscular organ, derives its nutrition from rasa, rakta and Oja. Functioning of Hrudaya is controlled by Vyana vayu.  Sadhaka pitta which can be correlated with intracellular enzymes in the cells of the Hrudaya helps to digest and utilise the Poshakatattva. Avalambaka kapha of Hrudaya can be correlated with the intracellular and interstitial fluid and chest. Any of the physiological entities i.e. rasa, rakta, mamsa, Oja, prana vayu, vyana-vayu, sadhaka pitta and avalambaka kapha when affected can disturb the function of the Hrudaya and cause disease of Hrudaya.

Older age is a risk factor for cardiovascular disease. In fact, about 4 of every 5 deaths due to cardiovascular disease occur in people older than 65. As we age, our hearts tend to not work as well. The heart's walls may thicken, arteries may stiffen and harden, and the heart is less able to pump blood to the muscles of the body. Because of these changes, the risk of developing cardiovascular disease increases with age. Because of their sex hormones, women are usually protected from cardiovascular disease until menopause, and then their risk increases. Women 65 and older have about the same risk of cardiovascular disease as men of the same age.

Degeneration of the blood vessels is caused by aggrvated vata molecules in the blood vessels, which make the blood vessels hard, thins dry and rough. Deposits of lipids and calcium represent deposition of kapha molecules in the degenerated vessels resulting in irregular thickening of blood vessels. The disease thus is caused by increased vata and vitiated kapha in the vessel wall. The treatment consists of proper diet and exercise which is beneficial to blood vessels and Hrudaya; and administering medicines, which have vatashamaka & kaphashamaka action particularly on the blood vessels.

Classification of Cardiovascular Disease from an Ayurvedic Perspective:

o   Adibalapravrutta: Hereditary Cardiovascular Disease e.g. metabolic diseases

o   Janmabalapravrutta: Congenital Cardiovascular Disease

o   Doshabala pravrutta: Vata, Pitta, Kapha, Sannipatika

o   Sanghatabalapravrutta: (a) Traumatic. (b) Poisoning

o   Kalabalapravrutta: Environmental or seasonal

o   Upasargaja: Infectious diseases e.g. Endocarditis, Myocarditis, Pericarditis

o   Swabhavabalakruta: Natural diseases e.g. ageing, death

o   Adhyatmika: Psychological factors leading to Cardiovascular Disease or hypertension

o   Daivabalakruta: Idoipathic, bad luck due to bad deeds of previous lives.

Other Probable correlation of Types of Hrud Roga with Cardiovascular Diseases:

• Vata Cardiovascular Disease can be correlated to Valvular Cardiovascular Disease, Cardiac arrhythmias, Angina pectoris, Constrictive pericarditis, Aneurysm and dilation of heart and aorta
• Pitta Cardiovascular Disease can be correlated to Myocardial infarction, Endocarditis including valvulitis, Myocarditis and pericarditis of all varieties.
• Kapha Cardiovascular Disease can be correlated to Metabolic disorders like glycogen storage of heart, tumours of the heart.
• Krimi Cardiovascular Disease: This type of Cardiovascular Disease is due to parasite, viral or bacterial infections. There are several Cardiovascular Diseases caused by macro and micro-organisms such as: Infective Endocarditis may result from infection by different micro-organisms and by fungi. Acute infection by trypanosoma cruzi will terminate in myocardial infarction within 20 to 30 days. Chronic form is characterised by disturbed cardiac rhythm (heart block and Adams syndrome). This is because of T. cruzi, which resides in the heart muscle during its infestation in the body. Toxoplasma gondii – its pseudocyst in muscle fibre of the heart will cause Myocarditis. Hydatid cyst of the heart may be caused by Echinococcus granulosus infestation.

Common Diseases seen in Cardio-Vascular System:

Caronary Artery Disease:

Coronary artery disease (also called CAD) is the most common type of heart disease found in old age people, and its find out only when they have a heart attack. Coronary artery disease occurs when fatty deposits called plaque build up inside the coronary arteries. The coronary arteries wrap around the heart and supply it with blood and oxygen. When plaque builds up, it narrows the arteries and reduces the amount of blood that gets to heart. This can lead to serious problems, including heart attack.

Ayurveda views atherosclerosis according to the symptoms. Degeneration of the blood vessels is caused by increased Vata in the blood vessels, which make them hard, thin, dry and rough. Deposits of lipids and calcium represents deposition of Kapha (water & earth element) in the degenerated vessels resulting in irregular thickening of blood vessels. Ayurveda therefore concludes that this disease is caused by an increase of Vata and vitiation of Kapha in the blood vessels.

Heart Attack / Myocardial Infraction:

A heart attack is an injury to the heart muscle caused by a loss of blood supply. The medical term for heart attack is "myocardial infarction," often abbreviated MI. A artery - a blood vessel that feeds blood to a part of the heart muscle. Interrupted blood flow to your heart can damage or destroy a part of the heart muscle.

Cardiomyopathy:

Cardiomyopathy means diseases of the heart muscle. Some types of cardiomyopathy are genetic, while others occur for reasons that are less well understood. Types of cardiomyopathy include ischemic, which is caused by loss of heart muscle from reduced coronary blood flow; dilated, which means the heart chambers are enlarged; hypertrophic, which means the heart muscle is thickened; and idiopathic, which means the cause is unknown. One of the most common types of cardiomyopathy is idiopathic dilated cardiomyopathy - an enlarged heart without a known cause.

Ayurveda would look at this as being associated with a pathology of Mamsa Dhatu and a blockage, caused by toxins in the Mamsa Vaha srotas.

Aneurisms:

An aneurysm is a bulge or weakness in a blood vessel (artery or vein) wall. Aneurysms usually get bigger over time. Because of that, they have the potential to rupture and cause life-threatening bleeding. Aneurysms can occur in arteries in any location in your body. The most common sites include the abdominal aorta and the arteries at the base of the brain.

Ayurveda classifies aneurysm as gulma and understands that this is caused by weakness of muscular tissue (Mamsa) and an increase in Vata.

Valvular Heart Diseases:

These are diseases of the heart valves. Four valves within your heart keep blood flowing in the right direction. Valves may be damaged by a variety of conditions leading to narrowing (stenosis), leaking (regurgitation or insufficiency) or improper closing (prolapse). You may be born with valvular disease, or the valves may be damaged by such conditions as rheumatic fever, infections (infectious endocarditis), connective tissue disorders etc.

Pericardial diseases:

These are diseases of the sac that encases the heart (pericardium). Pericardial disorders include inflammation (pericarditis), fluid accumulation (pericardial effusion) and stiffness (constrictive pericarditis). These can occur alone or together. The causes of pericardial disease vary, as do the problems they may lead to. For instance, pericarditis can occur after a heart attack and, as a result, lead to pericardial effusion or chest pain.

From and Ayurvedic perspective the inflammation (pericarditis) is associated with

Pitta, while fluid fluid accumulation (pericardial effusion) with Kapha and stiffness (constrictive pericarditis) with Vata.

Heart failure:

Heart failure, often called congestive heart failure, is a condition in which the heart can't pump enough blood to meet the needs of your body's organs and tissues. It doesn't mean your heart has failed and can't pump blood at all. With this less effective pumping, vital organs don't get enough blood, causing such signs and symptoms as shortness of breath, fluid retention and fatigue. "Congestive" heart failure is technically reserved for situations in which heart failure has led to fluid buildup in the body. Not all heart failure is congestive, but the terms are often used interchangeably. Heart failure may develop suddenly or over many years. It may occur as a result of other cardiovascular conditions that have damaged or weakened the heart, such as coronary artery disease or cardiomyopathy.

Ayurveda recognises that a mild disturbance in the balance of Vata, Pitta and Kapha in the heat muscle results in the impairment of the cardiac function, which is usually compensated by augmenting the heart rate and increasing the force of ventricular contraction. Marked disturbance in the balanced state of Vata, Pitta and Kapha in the heart muscle give rise to uncompensated heart failure.

High blood pressure:

High blood pressure (hypertension) is the excessive force of blood pumping through your blood vessels. It's perhaps the most common form of cardiovascular disease in the Western world, affecting about one in four Americans. Although potentially life-threatening, it's one of the most preventable and treatable types of cardiovascular disease. High blood pressure also causes many other types of cardiovascular disease, such as stroke and heart failure.

Stroke:

A stroke occurs when blood flow to the brain is interrupted (ischemic stroke) or when a blood vessel in the brain ruptures (hemorrhagic stroke). Both can cause the death of brain cells in the affected areas. Stroke is also considered a neurological disorder because of the many complications it causes. Other forms of cardiovascular disease, such as high blood pressure, increase your risk of stroke.

TREATMENT:

In Ayurveda, two type of drugs have mentioned

1. Which work on the Avalambaka Kapha  and Ojas, The drugs which work on the avalumbaka kapha is mostly Shita Verya e.g. Mukta.
2. Which increase the working capacity of heart. The drugs which give power to heart are mostly Ushna Verya e.g. Vanapalandu.

DIFFERENT PREPARATION IN CARDIOVASCULAR DISEASES

In Ayurveda preparations are of four types-

• Ekmoolika Herbal dravya
• Single Mineral Drugs
• Compound Herbal preparation
• Compound Herbomineral preparation

EKMOOLIKA HERBAL DRAVYA

·         Arjuna (Terminalia arjuna)

·         Karpoora (Cinnamomum camphora)

·         Hrudpatri (Digitalis purpurea)

·         Vanapalandu (Urginea indica)

·         Tamboola (Piper betle)

·         Peeta Karaveera(Thevetia nerifolia)

·         Tarunee (Rosa centifolia)

SINGLE MINERAL PREPARATION

·         Abhraka (Mica)

·         Suvarna (Gold)

·         Rajata (Silver)

·         Mukta (Pearl)

·         Heeraka (Diamond)

·         Sukti (Pearl Oyster)

·         Tankana (Borax)

COMPOUND HERBAL PREPARATION

·         Arjunarishta

·         Arjuna Ksheera paka

·         Lashunadi Vati

·         Lashuna Ksheera paka

·         Dasamoolapanchakola Kwatha

·         Pushkaradi Kwatha

·         Pathyadi Ghrita

COMPOUND HERBOMINERAL PREPARATIONS

·         Hrudayarnava

·         Hemagarbha potali

·         Hamsagarbha potali

·         Swasakasa Chintamani

·         Prabhakara Vati

This article was written by

DR.A.S.PRASHANTH

Professor

Department of Post Graduate Studies

Ayurveda Maha Vidyalaya

Hubli, Karnataka – 580024