HRIDROGA SAMPRAPTI

• DEFINITION:-)id baaQaaM p`kuva-int )d`aogaM tM p`caxato lImpairment of functions of heart is Hridroga.

• ]%qaana- AamaaSayasamau%qa• daoYa- i~daoYa• dUYya- rsa, r>, maaMsa, maod, Aaoja• sa`aotaoduYTIp`kar- saMga,

Aitp`vaRi<a, isaraga`Miqa• maaga-- maQyama• p`sar- rsavah, r>vah, Annavah,

manaaovah s~aotsa• sqaanasaMEaya- )dya• svaBaava- AaSaukarI, icarakarI

CLASSIFICATION OF HRIDROGA SAMPRAPTI

1. ACCORDING TO HETU2. ACCORDING TO SHATKRIYA KALA3. SAMANYA SAMPRAPTI4. ACCORDING TO AYURVEDIKA

GRANTHA

ACCORDING TO HETU

• IT IS CLASSIFIED INTO THRRE TYPES

1. MANASIKA- AHARAJA AND VIHARAJA

2. SHARIRIKA3. AGHATAJA

SAMPRAPTI ACCORDING TO MANASIKA HETU

• HETU- CHINTA, BHAYA, KRODHA, SHOKA, ETC.

• CHITNA AND ATIDHYANA- AGGRAVATION OF PRANA AND VYANA VAYU

CHINTA

AJIRNA

VITIATION OF PACHAKA AND SADHAKA PITTA

VITIATION OF KLEDAKA AND AVALAMBAKA KAPHA(HRIDAYA IS SITE FOR KAPHA)

SO IT CAUSES IMPAIRMENT IN FUNCTIONS OF HEART

IMPAIRMENT IN HEART AND RASA- RAKTA VIKSHEPANA

DHVANI VIKRUTI AND OTHER IMPAIRMENT OF HEART

• INVOLVED DHATUS, RASA, RAKTA, MANSA AND MEDA

• DHATUS WILL VITIATE UAPDHATUS• MAINLY SIRA AND SNAYU ARE

INVOLVED• ASHTABINDU OJA OR APARA OJA IS

SITUATED IN HRIDAYA

SAMPRAPTI ACCORDING TO SHARIRIKA HETU

• DUE TO AHARA-• HETU- ATIRUKSHA, SHUSHKA,

USHNA, GURU, SNIGDHA, KATU, LAVANA, AMLA RASATMAKA, KSHARIYA, MADHYATIREKA, ATYALPA BHOJAN.

• KAPHA MEDA SANCHAYA IN THE LUMEN OF CORONARY VESSELS (STROTORODHA).DEPOSITION OF KAPHA AND MEDA IN LUMEN OF CORONARY VESSELS.

↓

LESS BLOOD SUPPLY TO MYOCYTES↓

IHD DUE TO ATHEROSCLEROSIS (DHAMANIPRATICHAIA)

DHATU KSHAYAJANYA AHARA↓

IMPROPER NOURISHMENT OF DHATU WHICH ARE RELATED WITH HRIDAYA

↓IMPAIRMENT IN FUNCTION FOF HEART

↓HRIDROGA

DUE TO VIHARA-

VEGA VIDHARANA (SUPPRESSION OF URGE OF MUTRA AND PURISH)

APANA VAYU VIKRUTI

ACCUMULATION OF MALA IN THE BODY

UPWARD MOVEMENT OF APAN VAYU

VITIATION OF PRANA AND VYANA VAYU

IMPROPER RASA RAKTA VIKSHEPANA

DISTURBED NUTRITION

DIFFERENT KINDS OF HEART DISEASES

SAMPRAPTI ACCORDING TO AGHATAJA HETU

• HETU-KRIMI SANKRAMANA, AMAVATAJANYA HRIDROGA, CO-AGULATION CASCADE

SAMPRAPTI ACCORDING TO SHATKRIYAKALA

• HETU- IMPROPER AHAR, VIHARA, INSTABLE MENTAL STATUS

• SANCHAYA-ACCUMULATION OF KAPHA IN ITS SITE OF PREDOMINANCE I.E. CHEST REGION.

• SANCHAYA-INCREASE OF KAPHA IN CHEST REGION .INCREASED DOSHAS WILL FURTHER AGGRAVATE.

• PRASARA-THEY FLOW OUT OF THE SITE AND SPREAD ALL OVER THE BODY.VITIATES RASAVAHA AND PRANAVAHA STROTASA

• STHANASANSHRAYA-INCREASED DOSHAS LODGE INTO VARIOUS PARTS OF THE BODY LIKE CORONARY ARTERIES, VALVES OF THE HEART, MUSCLES OF THE HEART.

• VYAKTI-LEADING TO CORONARY ARTERY DISEASE (CHD), VALVAR ABNORMALITY, MYOCARDIATIS,ETC.

• BHEDA- IF LEFT UNTREATED THEN LEADS TO COMPLETE MANIFESTATION RESULTING IN DIFFERENT KINDS OF HRIDROGAS E.G.- HRUTSHULA, HRUD-DRAVA, ETC.

SAMANYA SAMPRAPTI OF HRIDROGA

• dUYaiya%vaa rsaM daoYaa ivagauNaa )dM gata: l

• )id baaQaaM p`kuva-int )d`aogaM tM p`caxato l l

(sauEaut ]<ar KMD)

VITIATION OF PRINCIPLESOF DIET AND OTHER NIDANA

MANDAGNI

AMOTPATTI

SAAMA RASA

VITIATED RASA+VAYUVITIATED RASA+ KAPHA +

PITTA

RUJA IN HEART STROTORODHA

OBSTUCTION OF PRANA VAYU

HRIDA BADHA

SAMPRAPTI ACCORDING TO ACCORDING TO AYURVEDIC

GRANTHA• ASHTANG HRIDAYA AND MADHAVA

NIDANA HAS BEEN DESCRIBED FIVE TYPES OF HRIDROGAS.

• THESE ARE NAMELY- 1. VATAJA 2. PITTAJA 3. KAPHAJA 4. SANNIPATAJA AND 5. KRIMIJA.

VATAJA HRIDROGA

• HETU- SHOKA, UPAVASA, VYAYAMA, RUKSHA, SHUSHKA, ALPA AND SHITA AHAR.

• RESULTS IN VATA PRAKOPA AT THE SITE OF HRIDAYA BY STHANASANSHRAYA PRODUCE HRIDROGA

PITTAJA HRIDROGA

• HETU-ATIUSHNA, AMLA, LAVANA, KSHARA, KATU RASATMAKA AHAR ALSO EXCESSIVE CONSUMPTION OF FOOD, AJIRNA BHOJANA, MADHYAPANA, KRODHA, ATAPASEVANA, ETC.

• CAUSE PITTA PRAKOPA AT THE SITE OF HRIDAYA LEADING TO HRIDROGA.

KAPHAJA HRIDROGA• SHOWS THE SYMPTOMS LIKE

HEAVINESS AT THE SITE OF HEART, STAIMITYA, KASA, TANDRA, JWARA, ANOREXIA, EXCESSIVE KAPHASHTIVANA

SANNIPATAJA HRIDROGA

• SHOWS THE SYMPTOMS OF ABOVE THREE TYPES.

• THE MAIN SYMPTOMS ARE VAIVARNYA, SHVASA, JWARA, SHULA, SHOTHA, HRID-DHVANIVIKRUTI.

KRIMIJA HRIDROGASUFFERING FROM TRIDOSHAJA HRIDROGA

CONSUMPTION OF TILA, DUGDHA, GUDA, ETC KAPHAKAR AHAR

GRANTHI UTPATTI IN THE HRIDAYA

THAT PART BECOMES VIKRUTA

PRODUCTION OF KLEDA BY RASA IN THAT VIKRUTA PART

KRIMI UTPATTI FROM KLEDA

HRIDROGA

COMMON SYMPTOMS OF HRIDROGA

• vaOvaNya-maUcCa-jvarkasaih@ka XvaasaasyavaOrsyatRYNaa p`maaoha: l

• Cid-: kfaot\ @laoSa$jaao|$icaXca )d`aogajaa: syauiva-ivaQaastqaa\nyao ll

(cark icaik%saa)

• Prana Vayu Vikruti- Shwasa, Kasa, Hikka, Moha;

• Vyana Vayu Vikruti -Hritspandan and Shotha;

• Rasa Dushti- Jwara, Trishna, Moha, Shotha, Kaphotklesha, Aruchi, Chardi; Rakta Dushti- Vaivarnya;

• Oja Dushti- Vaivarnya, Moha, Murccha and

• Mana Dushti- Utsahahani, Fear and Angasada

“PATHOGENESIS OF ISCHEMIC HEART DISEASE”

• DEFINITION-IHD IS THE GENERIC DESIGNATION FOR A GROUP OF CLOSELY RELATED SYNDROMES RESULTING FROM MYOCARDIAL ISCHEMIA AN IMBALANCE BETWEEN SUPPLY & DEMAND OF THE HEART FOR OXYGENATED BLOOD.

THE CLINICAL MANIFESTATIONS OF IHD CAN BE DIVIDED INTO FOUR

SYNDROMES-1. MYOCARDIAL INFARCTION (MI), 2. ANGINA PECTORIS, 3. CHRONIC IHD WITH HEART

FAILURE AND 4. SUDDEN CARDIAC DEATH

• Although only a single major coronary epicardial trunk may be affected, two or all three- left anterior descending (LAD), lateral circumflex (LCX), and right coronary artery (RCA) - are often involved

ANGINA PECTORIS • DEFINITION-ANGINA PECTORIS is a

symptom complex of IHD characterized by paroxysmal and usually recurrent attacks of substernal or precordial chest discomfort (variously described as constricting, squeezing, choking, or knifelike) caused by transient (15 seconds to 15 minutes) myocardial ischemia that falls short of inducing the cellular necrosis that defines infarction.

There are three over lapping patterns of

angina pectoris-1. Stable or typical angina, 2. Prinzmetal or variant angina and 3. Unstable or crescendo angina.

Stable or typical angina,

• Stable angina, the most common form and therefore called typical angina pectoris, appears to be caused by the reduction of coronary perfusion to a critical level by chronic stenosing coronary atherosclerosis.

• this renders the heart vulnerable to further ischemia whenever there is increased demand such are that produced by physical activity, emotional, excitement or any other cause of increased cardiac workload.

Prinzmetal or variant angina

• Prinzmetal variant angina is an uncommon pattern of episodic angina that occurs at rest and is due to coronary artery spasm usually there is an elevated ST segment on the electrocardiogram (ECG), indicating of transmural ischemia. Although individual with this form angina may well have significant coronary atherosclerosis, the anginal attacks are unrelated to physical activity, heart rate, or blood pressure

Unstable or crescendo angina

• Unstable or crescendo angina refers to a pattern of pain that occurs progressively increasing frequent, is precipitated with less effort, often occurs at rest, and tends to be of more prolonged duration

MYOCARDIAL INFARCTION

• MYOCARDIAL INFARCTION is also known as ‘Heart attack’, is the death of cardiac muscles resulting from ischemia. It is by far the most important form of IHD and alone is the leading cause of death. Most myocardial infarcts are transmural, in which the ischemic necrosis involves the full or nearly full thickness of the ventricular wall in the distribution of a single coronary atherosclerosis, acute plaque changes, and superimposed thrombosis.

• MI may occur at virtually any age. But the frequency rises progressively with increasing age and when predispositions to atherosclerosis are present, such as hypertension, cigarette smoking, diabetes mellitus, genetic hypercholestoremia, and other causes of hyperlipoproteinemia.

THE DESIGNATION CHRONICISCHEMIC

HEART DISEASE (CIHD) • THE DESIGNATION

CHRONICISCHEMIC HEART DISEASE (CIHD) is used here to describe the cardiac finding in patient, often but not exclusively elderly, who develop progressive heart failure as a consequence of ischemic myocardial damage.

SUDDEN CARDIAL DEATH (SCD)

• SUDDEN CARDIAL DEATH (SCD) is most commonly defined as unexpected death from cardiac causes early after symptom onset (usually within one hour) or without onset of symptom in many adults, SCD is a completion and often the first clinical manifestation of IHD.

• With decreasing age of the victim, the following nonatherosclerotic causes of SCD become increasingly probable – congenital structural or coronary arterial abnormalities, Aortic valve stenosis, Mitral valve prolapse, Myocarditis, Dilated or hypertrophic Cardiomyopathy, Pulmonary hypertension, Hereditary or acquired abnormalities of the cardiac conduction system, Isolated hypertrophy, hypertensive or unknown causes.