By Aalif Surti November 2004 There are multiple causes of a heart attack. many also are its remedies and ways to prevent it. While different therapies offer different medications, ultimately all efforts are geared towards creating a balanced, more healthy lifestyle Risk factors for heart attack Modifiable risk factors • Hypertension • Diabetes mellitus • Use of tobacco • High levels of ‘bad’ cholesterol in the blood • Reduced physical activity • Obesity Non-modifiable risk factors • Age • Male sex • Family history of heart diseases Less important risk factors • Type ‘A’ personality • Inadequate ‘antioxidants’ that prevent oxidation of cholesterol • Excessive Homocysteine that can cause atherosclerosis. Symptoms of heart attack • Uncomfortable pressure, squeezing, pain or a burning sensation in the centre of the chest lasting for more than few minutes. • Mild or severe pain located in the front, middle or left part of the chest, upper part of the abdomen, neck, jaw, arms or shoulders. • Pain in the left shoulder, left arm, neck, jaw or upper back. • Chest discomfort attended by light-headedness, fainting, sweating, nausea or breathlessness. • Increased or irregular heart beat. Box on page no. 20 Controlling risk factors of Atherosclerosis • Quit smoking. Smoking increases the risk of cardiac death by 20-30 per cent. Even after quitting, it takes two years for this risk to be nullified. • Maintain normal cholesterol level in the blood by following dietary advice and taking medicines, if prescribed. Effective reduction of cholesterol decreases the risk of heart attacks and cardiac death by about one-third. • Maintain blood pressure at normal levels. Untreated hypertension increases the risk of heart attack by two to three times. • Maintain blood sugar at normal levels. Diabetes increases the risk of cardiac death by two to three times. • Make your lifestyle ‘heart friendly’. Shed extra flab and exercise regularly, as it decreases the risk by 25 per cent. AllopathyHeart attack or ‘myocardial infarction’ is a sudden interruption of blood supply to any portion of the heart muscle causing its death. A heart stroke causes permanent damage to the heart, as the dead cells cannot be replaced by the multiplication of remaining portion of the healthy heart muscle cells. Overview: The impure blood collects carbon dioxide from the various parts of the body and enters the heart’s right atrium. It then moves into the right ventricle that pumps the impure blood into the lungs where the blood gives up carbon dioxide and absorbs oxygen. This purified blood enters the left atrium first and then the left ventricle, finally entering the main artery, aorta, that is further subdivided into several arteries. These arteries then supply the pure blood to various parts of the body. Both the left and right sides of the heart contract and relax simultaneously. Salient causes for a heart stroke: A blood clot (thrombus) in a damaged portion of one or more coronary arteries causes a sudden blockage in the affected artery, leading to a heart attack. Also, contraction in one or more parts of the coronary arteries restricts the blood supply to the affected part of the heart. This causes a cardiac arrest. Silent heart attack: A silent heart attack often goes unnoticed owing to the lack of symptoms. An ECG, if done later, usually diagnoses it. About one-third of heart attacks that do not cause death are indeed silent heart attacks. Angina: The location and nature of chest pain due to angina is similar to the chest pain due to heart attack. However, unlike a heart attack, the affected portion of the heart muscle gets its blood supply from a narrowed but not completely blocked artery. Thus the narrowed artery may provide adequate blood to the heart at rest, but fails to meet its oxygen demand during exertion. Other differences include: • Angina is less severe, lasting for not more than 10 minutes. • The pain can be relieved within a few minutes by taking adequate rest. Keeping a Nitrate tablet under the tongue also helps. Treatment• Bed rest for the first few days. • Regular monitoring of the heart through ECG. • Painkillers to relieve the chest pain. • Aspirin to reduce the risk of blood clots in the coronary arteries. • Intravenous Nitrates to widen the coronary arteries. • Beta-blockers and Angio-tensin-converting enzyme inhibitors for a long-term benefit. • Thrombolytic injection, in case the patient receives medical aid within six hours of an attack. • Balloon angioplasty is a sophisticated technique, and is very successful. Magnesium and calcium antagonists such as nifedipine, verapamil or diltiazem are also recommended in a few selective cases. AyurvedaAyurveda describes a concept called Ojas that is divided into Para Ojas and Apara Ojas. These are different forms of liquid that flow through the heart to the various parts of the body. Since the heart is a site of the Ojas, the latter’s malfunction increases the risk of a heart attack. Angina: Angina results when Kapha and Pitta doshas accumulate in the heart muscles. Its symptoms include suffocation, chest congestion, coma, fainting spells, palpitation, and a stabbing, stretching type of pain. Treatment: An intake of the following mixtures helps: • Equal parts of Haritaki and Vaca (1 gm) with 4-5 gm of honey twice a day. • 3-6 gm of Haritaki, Vaca, Pushkara, Shati, Pippali and dried ginger powder mixed with 100-250 ml of milk twice a day. • 1-3 gm of Pippali, Vaca and asafoetida (fried in ghee), rocksalt, dried ginger, Yavakshara, Sauvarkala lavana and Ajmoda with 1-3 gm of lemon, orange or honey twice a day. • 1-3 gm of Pushkara, lemon, sati, cinnamon bark, dried ginger and fruit of chebulic myrobalan bruised in water with 1 gm of yavakshara, 100 ml of rice water, 6-12 gm of ghee and 1 gm salt. • 500 gm of costus root powder, Mrita Sanjivanisura with 250 gm of Vatakulantaka rasa and honey every half an hour. • 2 gm of asafoetida, Vaca and costus root every two hours. • 250 mg of tablets prepared from Grewia hirsute (nagabala). Compound medicines recommended for angina include: • 125 gm of Makardwaja and mukta pisti with honey or the same quantity of kasturi bhairava rasa with honey. • One tablet of Yakuti with peppermint juice. • 500 gm of Deer Horn ashes with 250 Prabhakar vati or Hridayarnava vati three times a day. Dietary modifications include increased intake of soup prepared from cereals, banana, pumpkin, pomegranate, dried ginger, aniseed, garlic, cherubic myrobalan, long pepper and beetle leaves with their petals. Ayurveda also recommends some single medicines: • 2-5 gm of medicine prepared from any of the following with honey or water: Guggulu, Pushkarmula, Arjuna, chandan, ginger, Haritaki and Devadaru. • Curd, sugar, milk, sugarcane, grapes, dates and gulkand. • 2-5 gm of powdered Madhuyashti and Katuki serve as mild laxatives.Herbo-mineral preparations suggested are: • 250-125 mg of Prabhakar Vati, Visheshwar rasa or Trinetra rasa twice or thrice daily. • 250-500 mg of Rasa Sindhur, Krihsnabhra Bhasma, Makaradhwaja, Brihada Kastutribharava with honey twice or thrice a day. Precautions • Take large portions of green leafy vegetables and raw fruits. Avoid oil, non-vegetarian and processed food, including food rich in animal fat. • Reduce stress, and practise yoga and meditation. • Some nutrition supplements prevent excessive oxidation of cholesterol. • Some specific yoga asana; mudra and pranayam are also effective. HomoeopathyHomoeopathy seeks to eliminate a disease from its very roots. It pays special attention to the following: • Mental stress: People subjected to grief, shock, ‘Type A’ personalities with erratic working hours, chain smokers and heavy drinkers are prone to heart attacks. Medicines like Staphysagria, Argentum Nitricum, Arsenic Album and Phosphorous can help. • Family history: Homoeopathic medication investigates the family history for a proper treatment of the disease. Medicines like Thuja, Tuberculinum, and Medorrhinum are recommended. • High cholesterol level: While Cholesterinum enhances the functions of the liver so that the rate of cholesterol utilisation increases, Calcarea Carb is prescribed for obese people. Carduus Marianus peps up the sluggish activity of the liver and pancreas. • Atherosclerosis: Medicines like Baryta Mur, Kali 10D, Amyl Nitrosum, Arsenic 10D and Adrenaline decelerate the progress of Atherosclerosis. They relieve symptoms of chest pain, high blood pressure and breathlessness. Nature CureNature cure can help prevent angina and heart attack, but offers no ready treatment. A change in diet (avoiding animal and dairy products, and chlorinated water), regular exercise (accompanied by deep breathing, using abdomen muscles, not chest muscles) can bring down the risk of a heart attack. Besides these, yoga, meditation and adequate sleep help reducing stress. Treatment: In case of angina pain, practise these for immediate relief: • Fomentation of the heart region for about five minutes dilates small blood vessels of the skin in the region. • Cold compression (with ice) on the heart region for half an hour, followed by rubbing the same part with your hands or sponging with hot water for five minutes. • Hydrotherapy to the affected area brings instant relief. • Take fruit juices, coconut water and vegetables to get rid of toxins. UnaniIn Unani jargon, the heart is a part of the Aza Raisa (vital organs). When the Quwat Haivanya (controller of all activities in the heart) is unable to meet the heart’s demand of in
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