HRIDROGA.pptx

Hridroga /Heart Disease in Ayurvedic classics. Published Research papers. Medications for the treatment.

1. HRIDROGA DR. BIKASH MAHARJAN ASST. PROFESSOR DEPT. OF KAYA CHIKITSHA PAMCARC

2. Historical review First known description regarding the importance of hridaya yantra can be traced back to athrava veda . ( atharva veda 19/9/4) It describes their understanding regarding the functioning of the heart and its relation to life and death. The term HRIDAYAMAYA describes to the desires involving the heart. In Yajurveda there is a very good reference stating that the heart resided in the chest between neck and naval, 12 fingers in breadth above the naval. Also the central situation of the heart was mentioned along with the deviation to the midline. It is said to resemble a large lotus kept upside down with its tip to the left .

3. VARIOUS WORDS WITH THEIR INTERPRETATION : Indha - Pulmonary aorta Virat - heart Lohita pinda - flaps of auriculo -ventricular Antar hrudaya jalaka - network with the heart-Chordae tendinae Sritih sanchari - circulatory opening Kesah sahastrardha nadi - blood capillaries

4. CHARAKA SAMHITHA Charaka gave two synonyms to hrudaya namely ‘ mahat ’ and ‘ artha ’ (C.Su.30/7) Hridaya and relation to srotas in viman sthana : Hridaya has been described as the origin of the prana vaha srotas along with rasa vaha srotas . ( C.Vi . 5/7) It has been described as one of the trimarmas in chikitsa sthana , Trimarmeeya adhyaya chikitsa . ( ref- ch.chi 26) Above references from viman sthan clearly state the importance of heart by describing it as the origin of the pranavaha srotas and hence its role in preserving life is identified.similarly describing it as the origin of the rasavaha srotas,its importane in circulation has been identified.

5. Susrutha samhitha In S usruta Samhita, the heart has been described as the seat of chetana . Ref su.sa 4/30 By describing it as the seat of chethana , it implies that normal functioning of the heart is responsible for chethana ( life) and vice versa. Moreover, Susruta Samhita clearly describes the pain of Myocardial Ischaemia (angina pain) in such a way that it cannot be bettered even now. Dhanvantari describes the symptoms of the heart disease and impending the death due to heart attacks. Patient may feel pricking pain and pain may be so severe resembling the pain of splitting the chest into two halves with an axe.

6. ASTANGA HRUDAYA In astanga hrudaya the set of vyana vayu has been described with resemblance to the heart along with its functions and relation to circulation (ref: A.H.12/6 ) SARANGADHARA SAMHITHA Sarangadhara samhitha contains the earliest description of circulation and respiration and their relation. He says that nabhigata pranavata comes out through kantha after touching the interior of the heart- HRIT KAMALANTARA to take Vishnu padamurta or ambara peeyusha (oxygen). After having taken the peeyusha it goes in very quickly and nourishes the body, maintains life and lightens the jatharagni . ( ref- Sa. Sam.Pur . Kha . 6/89,90)

7. BHAVA PRAKASHA Bhava misra was the first person to classify and describe over 50 drugs as hridyam . Moreover he was the first person to advocate the use of arjuna churna along with milk or ghee in various heart diseases. BHAISAJYA RATNAVALI Bhaisajya ratnavali is an extensive compilation of various herbal drugs and herbo -mineral drugs that can be used in hridroga in general and vataja hridroga in particular.

8. Nidana : 1. AHARAJA NIDANA ADHYASAN : In spite of incomplete digestion of food, consuming more food USHNA SEVANA : over indulgence in ushna padarthas . MADYATI SEVANA : Excessive intake of alcohol. Excessive intake of Kashaya , tikta rasas .

9. 2. VIHARAJA NIDANA : DIVA SWAPNA : sleeping during daytime particularly after consuming food. AVYAYAMA : lack of physical activity or excessive ATIVYAYAMA : excessive indulgence in exercise. VEGA DHARANA or VEGA NIRODHA : postponing 13 natural urges as described in Ayurveda . Passing out of apana vata if suppressed creates upward pressure on the heart. There is a special reference that srama swasa nigraha in particular leads to heart diseases. DHUMA PANA : Excessive smoking. ATI MAITHUNA : Excessive indulgence in sex.

10. MANASIKA KARANAS CINTA : excessive worry. BHAYA : Excessive fear- causes vata prakopa ATIKRODHA : Excessive anger- causes pitta prakopa TRASA : trouble OTHER CAUSES : 1. ABHIGHATA- Injury especially to heart and blood vessels. 2. GADATICHARA- Chronic diseases 3. AMA – incomplete or improperly digested food 4. KARASANI – chronic debilitating diseases characterized by acute loss of weight. 5. ATI VAMANA ATI VIRECHANA causes vata prakopa ATI VASTI

11. TYPES HRIDROGA can be broadly classified as follows – Nija Agantuja Nija type of Hridriga can be further divided into 4 varieties- a.VATAJA HRIDROGA b. PITTAJA HRIDROGA c.KAPHAJA HRIDROGA d.SANNIPATAJA HRIDROGA KRIMIJA HRIDROGA comes under the agantuja hridroga

12. SAMPRAPTI

13. SAMPRAPTI

14. SAMPRAPTI GHATAKA DOSHA - VATADI TRIDOSHAJA,VATA PRADHANA DUSHYA -RASA, MEDA SROTAS -RASAVAHA, PRANAVAHA ADHISTANA -HRIDAYA SROTODUSHTI -SANGA SWABHAVA - CHIRAKARI AGNIDUSHTI -AGNIMANDYA SADYAASADYATHA-YAPYA

15. Vatika hridroga lakshana : Hridaya ayamyata Hridaya tudyata Hridaya nirmathyata Hridaya deeryata Hridaya sphotyata Hridaya patyata

16. Pittaja hridroga lakshana : Tamo darsana Daha Moha Santrasa Taapa Vriddhi Jwara Pita bhavata Trishna Osha Chosha Hridaya klama Dhumayana

17. Kaphaja hridroga lakshana : Hridaya sthabdtha Hridaya gurutha Hridaya sthaimithya Kapha praseka Jwara Kasa Tandra Aruchi Agni mardavam Asya maduryam

18. Krimija hridroga lakshana : Teevra toda Kandu Uthklesha Steevanam Hrillasa Tamas Aruchi Syava netrata Sosha

19. UPADRAVAS OF HRIDROGA KLOMA SADAM- wasting of kloma BHRAMA- Giddiness SOSHA- wasting

20. SADHYASADHYATA: According to Bhela Vataja , pittaja , kaphaja - sadya However hridroga being a marmasruta vyadhi is considered as Kasta sadhya or asadhya .

21. Chikitsha In Vataja hridroga , before vamana is undertaken, sneha pana has to be administered to the patient then the actual procedure has to carried out by administering DWIPANCHAMOOLADI kwatha along with sneha and lavana . In P aittika hridroga , lepana and parisechana with sitala drugs should be done. Multethi and kutaki should be mixed with misri jala for drinking. In K aphaja hridroga , first swedana karma is to be performed followed by vamana by administering a mixture of vacha and nimba kashaya .

22. 4. In Krimija Hridroga , Sneha mishrita mamsa , rice and curd should be mixed with tila churna and intook for 3 days. After proper oleation , virechana should be done. Langhana should be followed by pachana and krimi roga should be treated with krimighna medicines.

23. Shamana ousadha 2. VATI Kankayana vati nikumbadya gutika Abaya vataka shambukadya gutika kalyanaka gutika Laghu shiva gutika Sapta chatwari satika guggulu Arogya lavana Surya chandra prabha gutika RASA/BHASMA Mrigasrungi bhasma Ratna vijaya parpati Hridayanarva Rasa Chintamani rasa Chandrakanta rasa Mahakalyana rasa 3. CHURNA Dadimastaka eladya churna Vidangadya churna Surasadya churnam Lavana bhasakara churnam Hingwastaka churnam Vyoshadhi churnam

24. Shamana ousadha 5. ASAVA/ARISTA Lohasava Kanakarishta 4. KWATH Kaserukadi kwath Katphaladi kwath 6. GHRITA Arjuna ghrita Dadimadya ghrita Devadaryadya ghrita Jivakadi ghrita Kamadeva ghrita Lasuna ghrita Mahatikta ghrita 7. TAILA Prasarani Taila Sukumari taila Syonaka taila 8. LEPA Manashiladi Lepa Switranashak Lepa Karviradi Lepa

25. CLINICAL EVALUATION OF AN INDIGENOUS COMPOUND DRUG IN HRIDROGA WSR TO LEFT VENTRICULAR DYSFUNCTION It was observed that there was significant improvement in clinical features of LVD like breathlessness, chest pain,andfatigability after the therapy in Group I & III, in which Cardi-16 was administered.[Table 2, 3 &4]. Patients subjected to the treatmentwith Cardi - 16 also reported increase in their urine output. Reduction in diastolic blood pressure was also observed in patients with mild hypertension . Probably this way the drug has facilitated reduction in afterload and improvement indiastolic function. Drug has also exhibited positive inotropic activity.

26. EFFICACY OF HEART FAILURE REVERSAL TREATMENT IN PATIENTS WITH LOW EJECTION FRACTION  Conclusion HFRT promises significant therapeutic effects with improvement in MAC and no safety concerns. This non-invasive ayurvedic regime can be considered as a good candidate to be included in maintenance treatment of patients with CHF.

27. MANAGEMENT OF CONGESTIVE CARDIAC FAILURE WITH CERTAIN AYURVEDIC DRUGS 2. SALUTARY EFFECT OF TERMINALIA ARJUNA IN PATIENTS WITH SEVERE REFRACTORY HEART FAILURE ALSO GO THROUGH THESE ARTICLES: