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2 Coronary Artery Disease: Ayurveda Perspective i

3 EDUCREATION PUBLISHING Shubham Vihar, Mangla, Bilaspur, Chhattisgarh Website: Copyright, 2017, Author All rights reserved. No part of this book may be reproduced, stored in a retrieval system, or transmitted, in any form by any means, electronic, mechanical, magnetic, optical, chemical, manual, photocopying, recording or otherwise, without the prior written consent of its writer. ISBN: Price: ` The opinions/ contents expressed in this book are solely of the authors and do not represent the opinions/ standings/ thoughts of Educreation or the Editors. The book is released by using the services of self-publishing house. Printed in India ii

4 Coronary Artery Disease: Ayurveda Perspective BY Dr. Sandeep V. Binorkar Dr. Guruprasad K EDUCREATION PUBLISHING (Since 2011) iii

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6 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 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 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. ****** v

7 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. ****** vi

8 CONTENT LIST Chapter Title Page 1. Introduction 1 2. Anatomy & Physiology of the Heart 3. Prevalence of Coronary Artery Disease (CAD) Present Scenario of CAD In Kerala Etiology of CAD Pathophysiology of CAD Presentation of CAD Diagnosis of CAD Management of CAD Prognosis of CAD Prevention of CAD Ayurveda & Coronay Artery Diseases Classification of Heart Disease Nidana of Hridroga Clinical manifestation of Hridroga Samprapti Management of Heart Disease Oushadha yoga Pathya.-Apathya Role of Yoga In CAD 112 vii

9 21. Discussion Recommendations Summary Conclusion Abbreviations Bibliography 142 ***** viii

10 Coronary Artery Disease: Ayurveda Perspective Chapter -1 INTRODUCTION Úðô ÃððèðÜòãðèðÜçÚð Úðô Ãðµð æ çúð îùðáçðô / Úðô 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 1

11 Dr. Sandeep V. Binorkar, Dr. Guruprasad K 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 2

12 Coronary Artery Disease: Ayurveda Perspective 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 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. ***** 3

13 Dr. Sandeep V. Binorkar, Dr. Guruprasad K 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 upsidedown 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. 4

14 Coronary Artery Disease: Ayurveda Perspective 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. 5

15 Dr. Sandeep V. Binorkar, Dr. Guruprasad K Pulmonary Artery The pulmonary artery is the vessel transporting deoxygenated blood from the right ventricle to the lungs. A common misconception is that all arteries carry oxygenrich 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 6

16 Coronary Artery Disease: Ayurveda Perspective 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. 7

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