What
is Angina ?
Cardiac
problems arise mainly due to improper diet and stressful life styles.
" These lead atherosclerosis known as dhamani praticaya or hardening
of arteries dhamani kathinaya resulting in angio-obstruction recognised
as a vata dosha in ayurveda and this leads to angina (ruja). "
What
is Angina Pectoris?
Angina
Pectoris is a clinical syndrome rather than a disease. This denotes
a discomfort due to transient myocardial ischemia (deficiency of blood
in a part). Almost every adult faces this problem sometime in his lifetime.
It's not the same as a heart attack, but because of the severity of
pain, it often seems like one. When one experiences this anginal pain
he becomes very conscious, frightened and always misconceives it with
Myocardial Infraction (Heart attack).
Angina
is one of the first signs of serious heart disease. The same disease,
'Atherosclerosis' - causes this, the deposits of fatty cholesterol substances
in the walls of arteries that cause blockage or plagues. Most heart
attacks occur because of a clot, which forms at the site of a plague
and suddenly obstructs a coronary artery. When you take steps to prevent
angina pectoris, you are also taking steps to prevent heart attacks.
Don't
expect any warning that will enable you to prevent the disease. You
don't have then time to change your way of living. You have to follow
these measures that will protect you from Angina.
What
causes Angina?
Let’s first know, how is your heart is supplied by blood. You
have two main coronary arteries, the right and the left. These start
at the beginning of the aorta (The beginning of arterial system). As
oxygen contained (oxygenated) blood is pumped out of your heart, these
first branches from the aorta are filled with this oxygenated blood
to supply your working heart muscle.
Your left coronary artery quickly divides into two main branches and
supplies front and left portion of your heart, while right coronary
artery mostly supplies backside of your heart. These three main arteries
branch continuously, and their smallest branches connect together to
form a network of arteries.
These smallest arteries can become functionally closed, in inactive
individuals. When you exercise, they open to help in increasing the
blood flow to your heart. Those open connections also help to provide
subway around obstructed arteries called as “collateral’s”.
That helps to prevent angina pectoris and heart attacks. The most common
reason the blood flow through the coronary arteries cannot be raised
is because of fatty cholesterol deposits called ‘Plaques’
that obstruct the arterial passage. Thus whenever a major coronary artery
is narrowed too much it unable to increase blood flow through it when
heart needs more oxygen, even obstructs normal blood flow. The blood
platelets start the formation of blood clots and aggregates at spots
where plaque has formed. They release substances that cause the coronary
artery to go into spasm and reduce circulation, which causes angina.
What
are the signs and symptoms of Angina ?
Typical anginal pain's sight is most often over middle or lower breastbone,
at times in epigastrium. Sometimes discomfort is located only in left
shoulder or left upper arm, occasionally in lower jaw or in interscapular
area.
Character
- Vice like constriction or choking. Sometimes feels pressure like weight
on their chest or burning pain, rarely mere weakness of one or both
arms. An important characteristic is its constancy, the pain being steady
while it lasts.
Duration
- One of the most important characteristics of the discomfort is its
duration. Usually lasts for one to four minutes may force patient to
stop walking.
Radiation
- May spread to left or right arm or both, neck or jaw. Sometimes pain
starts in the wrists, upper arms or face and then spreads to the chest.
Provocation
- Occurs with exertion like walking against the wind, or up climb cold
weather. The combination of walking in the cold is apt to cause anginal
pain. Hurrying after meals or unaccustomed exercise, due to excitement,
anger, fear. In advanced cases pain is aggravates by lying down, violent
dreams.
Relief
- With sublingual nitroglycerine (temporary).
Other
symptoms:
• Choking sensation in throat or feeling of impending doom.
• Belching or passage of flatus or increased urination after an
attack.
• Dizziness, faintness.
• If pain is severe sweating and nausea may persists.
• Tachycardia and rise in Blood Pressure.
It is important to recognize that the heart does not cause all chest
pains. Some of the conditions that can be confused with it are:
• Painful rib joint (costochondritis)
• Arthritic pain
• Muscular pain
• Pleurisy
• Paricarditis
What
are the preventive measures?
Preventing the fatty cholesterol deposits and reversing those that have
already occurred is a primary (prior) prevention. Early stages of this
disease can be reversed in many instances. Under the right conditions,
the early plaque can be dissolved; the more mature plaque cannot be
eliminated.
There are many factors that help in forming the plaque, and these are
called risk factors. These are five most important risk factors, Age,
sex, blood pressure, cholesterol and smoking.
You can’t do anything about age and sex, but you can do a lot
about the other risk factors and the many others who affect them such
as diet and exercise.
One who is learned about the cause of plaque, ways to prevent it, and
importantly, applying those ways, it is possible that age and even sex
will not be considered such an important risk factor.
Sex- In general, heart attacks occur in women
about ten years later than they do in men. Women become much more susceptible
to heart attacks after they go through the menopause.
Cholesterol - is an important factor in causing
coronary artery disease as much of the plague that forms is from cholesterol.
Among all cholesterol, the LDL cholesterol is the one who most likely
to cause fatty cholesterol deposits and hence called as “bad -
cholesterol”. The HDL cholesterol, removes cholesterol from deposits
that occur in your arteries, having just the opposite effect of LDL
and that is why it is called " good cholesterol".
Blood -Pressure - High Blood pressure is one
of the main causes for fatty cholesterol deposits in the coronary arteries.
As a result, it is a common factor in causing angina pectoris and heart
attacks from coronary insufficiency. High Blood pressure alone increases
the risk of a heart attack, but when a person also has a high total
cholesterol level, the risk is greatly increased.
High pressure causes the arterial wall to thicken and more deposits
will occur. The muscular layer enlarges in response to several complex
mechanisms that cause muscle growth. It causes the left ventricle to
work harder and to enlarge. The enlarged heart muscle works harder needs
a greater blood flow to supply it with more oxygen. At the same time,
the coronary arteries may be affected, with enlarged thickened walls
and fatty cholesterol deposits. That may limit how much increase in
blood flow through the arteries can be obtained. As a result, the heart
muscle may be weakened. The lower your blood pressure, the less likely
you are to have coronary artery disease.
Smoking - The more you smoke, the greater is the risk, but even smoking
a few cigarettes can increase your risk of a heart attack. Even smoking
a single cigarette can cause the platelets (The tiny cells that start
the formation of a blood clot) in your blood stream to clump. This also
causes coronary spasm (due to this clump), which releases some substances
that causes spasm.
What
should I do to prevent it?
Get yourself acquainted with following preventive measure:
• Any effective measure that helps to improve cholesterol levels
can be a factor in preventing progression of fatty cholesterol deposits
that is a root cause of all coronary diseases or reversing the early
ones.
• For the more ideal situation, you probably should have total
cholesterol below 200 and HDL cholesterol at 50 or above. That does
not mean you need to take some drastic measures to achieve these ideal
goals, particularly in terms of taking medicines, but you can do this
with your lifestyle, that will significantly decrease your risk of having
a chest pains or heart attacks.
Take diet low in cholesterol, restrict the total dietary fat consumption
and saturated fat's, limits your calorie intake sufficiently to prevent
or eliminate excess body fat.
•
Omit oily / fried foods in your diet, adopt oil free kitchen techniques
like roasting, baking etc. As one of the most important risk factors
is obesity. Try to minimize your weight if you are obese. Even if you
are having controlled weight, loosing some fat layers will help you.
Obese individual who did not have abnormal cholesterol levels, high
blood pressure or abnormal blood glucose must not ignore his over weight.
• Control your blood glucose level.
• A low fat vegetarian diet is rich in vitamin A, C, and E, which
are antioxidants in property that have been found to help control or
prevent angina.
• Go for a vegetarian diet as they are devoid of excess fat. If
you still want to eat meat, fish or poultry you should limit it. If
your diet consists mainly of vegetables, fruits and whole grains, then
you're getting all the nutrients you need.
• If you belong to these families that have heart attacks early
in life are much more prone to coronary heart diseases. So you must
take extra precautions to control risk factors to delay the onset of
disease.
• Stop smoking as this also increases heart rate which increases
the heart's oxygen demand.
• Heavy use of alcohol can damage the heart muscles and is often
associated with high blood pressure. So minimize or stop alcohol consumption
as sometimes-anesthetic effect of it prevents original pain which blocks
the warning sign that is chest pain but still your heart suffers from
inadequate circulation.
• Exercise - Start regular exercising according to your current
level of physical fitness and the state of your health. Exercise helps
you a lot in preventing or eliminating excess body fat; this itself
will lower blood pressure also. This will also open those small connecting
network of arteries within the heart muscle and improves the heart muscles
efficiency in utilizing oxygen. Exercise prevents blood clotting according
to research [Your body produces an enzyme which protects against the
formation of blood clots].
• Tobacco and caffeine are tend to increase blood pressure so
stop them if you are hypertensive or minimize it (coffee).
• As Angina mostly precipitates with anxiety or stress, try to
minimize this by yoga or meditation. The stress increases the work of
the heart and it's need for oxygen.
• Above all, if you experience angina attacks raise the head of
your bed or sit because lying position may aggravate pain. This posture
eases you in aching.
• Exercising in cold or in polluted places (carbon monoxide) can
trigger angina attacks is some people. So try to avoid this.
How Ayurveda can help?
According to ayurved, vitiated vata generates all types of pain. Anginal
pain is also of vata origin; vata vitiates mainly due to two reasons,
Dhatu-kshaya and any obstruction in its natural path. So the treatment
depends on these two factors. Whenever first you feel chest pain, rush
to your doctor and as per his advice do necessary pathological, radiological
investigations. If the Angina is confirmed start medications. Assuming
any chest pain to be Angina and starting self-medication is hazardous.
We
will discuss some of formulations, which alleviate Heart pain (Hrut
shool). Please consult a qualified physician before starting any medications.
1. Paste of Pushkarmool, Sunthi and shathi mixed with alkali water (ksharodak),
ghee and salt alleviates cutting pain in heart.
2. A decoction of Triphala can be used.
3. A decoction of Musta, Haridra, Daruharidra, Vacha, Kushtha, Chitraka,
Katu rohini etc works as emaciating remedy. Thus this may help in reducing
fatty cholesterol deposits and also acts on obesity.
4. Powder of Yavakshara and Yavani mixed with warm water should be drunk.
5. Decoction of Arjuna bark added with milk (1:4) is to be boiled with
four parts of water, until only milk is remained. This is to be taken
with Sharkara( sugar) .
6. Decoction of Erandmool twak added with Yavakshara is to be taken.
This pacifies hrutshoola (Heart pain).
7. Decoction of Dashmoola, added with Saindhava and yava-kshara helps
you in decreasing weight and also alleviates chest pain.
8. Mruga shringa bhasma with cow's ghee is to be taken it alleviates
pain.
9. Powder of Pushkarmool added with honey is to be taken orally.
Do's
-
Have Old sali rice, wheat, yava, mudga (green gram), horse gram, cabbage,
gourd, serpent gourd, Alibanam (Tendil), ginger, garlic, Onion, Dry
ginger, Old pumpkin Pomegranate, mango, grapes, lemon, Orange, Honey,
hot water, Cow's ghee, Ajawayn, Safflower oil, Sunflower oil, Regular
exercise- walking, yoga etc.
Dont's
-
Eat Maize. Jawar, Varak, Pot hurbs, bitter gourd, Sago ,Pea, Black gram,
Cow pea, Kidney beans, fish, Aquatic animals meat, Red meat, Milk, Milk
products, Potato, Sweet potato, Coconut, Custard ,apple, Strawberry,
Pineapple, dry fruits (cashew, almond etc), betel nut, fried food, junk
food, tobacco, alcohol etc.
We
offer some classical Indian supportive remedies for this disease which
are supposed to be taken strictly under medical supervision. Kindly
Ask a Doctor
