Sample Copy. Not For Distribution.14. Nidana of Hridroga 84 15. Clinical manifestation of Hridroga 85 16. Samprapti 87 17. Management of Heart Disease 89 18. Oushadha yoga 103 19.

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i

Coronary Artery

Disease: Ayurveda Perspective


ii

EDUCREATION PUBLISHING

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Printed in India


iii

Coronary Artery

Disease: Ayurveda

Perspective

BY

Dr. Sandeep V. Binorkar Dr. Guruprasad K

EDUCREATION PUBLISHING (Since 2011)

www.educreation.in


iv


v

About Authors

Dr. Sandeep V. Binorkar is working as

Assistant Professor in the Dept. of Agadatantra & Vyavahara Ayurveda

(Ayurvedic Toxicology & Forensic

Medicine) at Government Ayurveda

College, Nanded, Maharashtra state, India,

since 2012. Previously he worked for

seven years in various institutes over the country. He has pursued his Ayurveda degree from Dr.

Babasaheb Ambedkar Marathwada University,

Aurangabad, Maharashtra state and his Post graduate

[MD (Ayu)] from one of the renowned Ayurveda institutes,

VPSV Ayurveda College, Kottakkal under the University of

Calicut, Kerala state. His research was bestowed with Kerala Ayurveda Research Award 2007. He has more than

11 years of teaching, training & research experience. He

has published more than 40 research papers in peer

reviewed international journals, authored 5 books, has

presented in number of national and international

conferences and is one of the distinguished faculty on the

editorial /reviewer board of various International journals of Ayurveda, Yoga, Alternative Medicine, Forensic

Medicine & Toxicology. His areas of interest are toxicity

studies, clinical and in vitro trials, forensic medicine and

Ayurveda.

******


vi

About Authors

Dr. Guruprasad K is working as

Associate Professor in the Department of

Swasthavritta and yoga at Sri Jayendra

Saraswathi Ayurveda College and

hospital. He holds Post graduate degree in

Ayurveda (Swasthavritta) and Msc (Yoga Therapy). He has pursued his Ayurveda

degree from Taranath government

Ayurveda medical college, Bellary, Karnataka and Post

Graduation from SDM college of Ayurveda and Hospital

Hassan, Karnataka. He has more than 12 years of

teaching, training & research experience. He has worked as coordinator for Reproductive and child health care

project in Bharathiya Samskrithi Prabhodini, Goa which

was sponsored by central government. He has

participated in more than 20 International and National

seminars and CME in India. He has called as resource

person in CME at Govt Ayurveda College, Thiruvananthapuram, sponsored by Department of Ayush

and also resource person in State level seminar on

Therapeutic Yoga, held at Chennai. He has presented

papers in different National and international seminars

organized in India. He has published Review and research

articles in different international journals. His areas of

interest are Swasthavritta, Preventive and social medicine, General Yoga, Therapeutic Yoga, Life style

disorders, Ayurvedic Dietetics and Nutrition.

******


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CONTENT LIST

Chapter Title Page

1. Introduction 1

2. Anatomy & Physiology of the

Heart

4

3. Prevalence of Coronary Artery

Disease (CAD)

14

4. Present Scenario of CAD In Kerala 17

5. Etiology of CAD 20

6. Pathophysiology of CAD 33

7. Presentation of CAD 37

8. Diagnosis of CAD 43

9. Management of CAD 49

10. Prognosis of CAD 61

11. Prevention of CAD 63

12. Ayurveda & Coronay Artery Diseases

70

13. Classification of Heart Disease 82

14. Nidana of Hridroga 84

15. Clinical manifestation of Hridroga 85

16. Samprapti 87

17. Management of Heart Disease 89

18. Oushadha yoga 103

19. Pathya.-Apathya 110

20. Role of Yoga In CAD 112


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21. Discussion 128

22. Recommendations 133

23. Summary 134

24. Conclusion 137

25. Abbreviations 140

26. Bibliography 142

*****


Coronary Artery Disease: Ayurveda Perspective

1

Chapter -1

INTRODUCTION __________________________________________________________

Úðô©ÃððèðÜòãðèðÜçÚð Úðô©Ãðµð÷æ¿çÚð ¨îÙðáçðô /

Úðô̈ îþÃðçãðÑÐððãð×ðð÷ÏðçÚð

Úðð÷±ðð÷ØðãðòÃð Çô:®ðèð//

åóÙðÇþ Øð±ðãðÃð±ðóÃðð 6/17

A verse in the Bhagwad Gita, one of the most ancient

of Indian scriptures, clearly describes the virtues of

healthy lifestyle in prevention of infirmity and ill-health. The verse states that those who combine a balanced diet,

regular physical activity, regular hours, maintain

equanimity, and are balanced in thoughts and action, are

always free from sickness. This verse matches with the

current recommendations for several diseases prevention

propounded by the World Health Organization and various

international societies.

Next to life itself health is our most precious gift. But

most of us take it for granted until we are deprived of it.

Then we put forth every effort and of times spend more

than we can afford to regain our health. The lesion of

course is that we would be wise to guard our health while

we have it. This observation is so evident it would seem unnecessary to make the point. Yet so many shows by

the way they live that they are not diligent to preserve

their health. Either through ignorance or carelessness

they abuse their bodies and eventually reap the unhappy

results.

“An ounce of prevention is worth a pound of cure”


Dr. Sandeep V. Binorkar, Dr. Guruprasad K

2

At present era we all are running blindly towards

sedentary lifestyle and urbanization which is characterized

by a marked increase in the intake of energy-dense

foods, a decrease in physical activity, and a heightened

level of psychosocial stress, all of which promote the

development of dysglycemia, hypertension, and dyslipidemia.

Two thousand five hundred years ago Hippocrates,

the father of medicine noted that ―fat men die suddenly‖

This is still true. Not in ever case of course but sudden

death occur so often in fat people rather than in lean. In

other words ―The longer your waist line he shorter your life line‖

One of the major complications of this sedentary

lifestyle is cardiac ailment or heart disease. The human

heart is marvelous organ. Its function is to move the

living stream of blood through all parts of the body, never

stopping even for a moment in its endless activity.

Naturally to maintain all these activity, the heart must feed itself. It must also be constantly supplied with

oxygen. The hearts own blood supply is maintained by

two very important vessels known as the coronary artery.

Centuries ago early students of anatomy discovered these

vessels winding their way around the heart and thought

they resembled a crown –hence the name coronary. They are among the most important vessels in the body. If one

of these fails, the heart might stop and that would be the

end.

Coronary artery disease is the most common of all

forms of heart disease today. More people die from

coronary thrombosis than from all other forms of illness

put together including infections, accidents and cancer. Second half of the 20th century has witnessed a global

spread of the coronary artery disease (CAD) epidemic

especially in developing countries, including India.

Coronary Artery Disease (CAD) is defined as acute or

chronic form of cardiac disability arising from imbalance

between the myocardial supply and demand for oxygenated blood. Ischemic heart disease is the alternate



3

term used with CAD. It comprises unstable angina and

acute myocardial infarction associated with ST-segment

elevation or depression.

Based solely on projected demographic trends, it has

been estimated that deaths attributable to CAD would

nearly double, in both sexes, in the period 1985-2015 and CAD would emerge, over this period, as the single largest

contributor to mortality, accounting for nearly a third of

all deaths, globally.

To understand this predicament, Coronary Artery

Diseases, we have to review all available details regarding

the anatomy, physiology, risk factors, prevalence, best possible conventional treatment comprehensive Ayurvedic

healing if any.

The aim of the present work on ‗Coronary Artery

diseases‘ is to provide introduction to some of the ideas

and preoccupation of the same through ancient medical

tradition of Ayurveda.

*****



4

Chapter -2

Anatomy And Physiology of The Heart __________________________________________________________

Heart is located under the ribcage in the center of chest

between right and left lung. It‘s shaped like an upside-

down pear. Its muscular walls beat, or contract, pumping blood continuously to all parts of your body.

The size of heart can vary depending on age, size, or

the condition of heart. A normal, healthy, adult heart

most often is the size of an average clenched adult fist.

Some diseases of the heart can cause it to become larger.

Connected to the heart are some of the main blood

vessels—arteries and veins—that make up blood circulatory system. The human heart is actually two

pumps in one. The right side receives oxygen-poor blood

from the various regions of the body and delivers it to the

lungs. In the lungs, oxygen is absorbed in the blood. The

left side of the heart receives the oxygen-rich blood from

the lungs and delivers it to the rest of the body.

The ventricle on the right side of heart pumps blood

from the heart to lungs. When one breathe air in, oxygen

passes from lungs through blood vessels where it‘s added

to blood. Carbon dioxide, a waste product, is passed from

blood through blood vessels to lungs and is removed from

body when breathe air out.



5

Picture Shows The Front Surface Of The Heart, Including

The Coronary Arteries And Major Blood Vessels

Superior Vena Cava

The superior vena cava is one of the two main veins

bringing de-oxygenated blood from the body to the heart.

Veins from the head and upper body feed into the

superior vena cava, which empties into the right atrium of

the heart.

Inferior Vena Cava

The inferior vena cava is one of the two main veins

bringing de-oxygenated blood from the body to the heart.

Veins from the legs and lower torso feed into the inferior

vena cava, which empties into the right atrium of the

heart.

Aorta

The aorta is the largest single blood vessel in the body. It

is approximately the diameter of one‘s thumb. This vessel

carries oxygen-rich blood from the left ventricle to the

various parts of the body.



6

Pulmonary Artery

The pulmonary artery is the vessel transporting de-

oxygenated blood from the right ventricle to the lungs. A

common misconception is that all arteries carry oxygen-

rich blood. It is more appropriate to classify arteries as

vessels carrying blood away from the heart.

Pulmonary Vein

The pulmonary vein is the vessel transporting oxygen-rich

blood from the lungs to the left atrium. A common

misconception is that all veins carry de-oxygenated blood.

It is more appropriate to classify veins as vessels carrying blood to the heart.

Cross-Section of A Healthy Heart and Its Inside Structures

Right Atrium

The right atrium receives de-oxygenated blood from the

body through the superior vena cava (head and upper

body) and inferior vena cava (legs and lower torso). The



7

sino-atrial node sends an impulse that causes the cardiac

muscle tissue of the atrium to contract in a coordinated,

wave-like manner. The tricuspid valve, which separates

the right atrium from the right ventricle, opens to allow

the de-oxygenated blood collected in the right atrium to

flow into the right ventricle.

Right Ventricle

The right ventricle receives de-oxygenated blood as the

right atrium contracts. The pulmonary valve leading into

the pulmonary artery is closed, allowing the ventricle to

fill with blood. Once the ventricles are full, they contract. As the right ventricle contracts, the tricuspid valve closes

and the pulmonary valve opens. The closure of the

tricuspid valve prevents blood from backing into the right

atrium and the opening of the pulmonary valve allows the

blood to flow into the pulmonary artery toward the lungs.

Left Atrium

The left atrium receives oxygenated blood from the lungs

through the pulmonary vein. As the contraction triggered

by the sinoatrial node progresses through the atria, the

blood passes through the mitral valve into the left

ventricle.

Left Ventricle

The left ventricle receives oxygenated blood as the left

atrium contracts. The blood passes through the mitral

valve into the left ventricle. The aortic valve leading into

the aorta is closed, allowing the ventricle to fill with

blood. Once the ventricles are full, they contract. As the

left ventricle contracts, the mitral valve closes and the aortic valve opens. The closure of the mitral valve

prevents blood from backing into the left atrium and the

opening of the aortic valve allows the blood to flow into

the aorta and flow throughout the body.


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Sample Copy. Not For Distribution.14. Nidana of Hridroga 84 15. Clinical manifestation of Hridroga 85 16. Samprapti 87 17. Management of Heart Disease 89 18. Oushadha yoga 103 19.

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