Heart care - Prevention & Management - 1

Ayurveda is the science of life with emphasis on universal healthcare. It has stood the test of time because of how accurate & relevant it is. Hrudaya & Hrudroga are well documented & extensively discussed topics in Ayurveda similar to Cardiology being one amongst the widely researched areas in Western medicine. Cardiovascular diseases (CVDs) are known to rapidly turn fatal. Hence, these usually require either invasive procedures & / or lifelong medication and therefore are globally dreaded.

In India, CVDs are of particular concern because of growing increase in the number of cases, early age of disease onset, high death rate. Of all the causes of death in India, 25% is estimated to be due to CVD. Heart attack, Hypertension & other cardiovascular issues have become dreadfully common.
In this series, an attempt is made to introduce the reader to the notion of “Hrudaya & Hrudroga” in addition to the perceptions of “Heart & Cardiovascular ailments”.

Heart & Cardio-Vascular Diseases (CVDs)

The Western idea of “heart” generally brings into mind the picture of a hollow muscular organ that pumps & circulates blood by its rhythmic contraction & relaxation. Cardiology refers to the branch of medicine which mainly deals with the heart & to an extent, the circulatory system. The heart is located below the sternum, in mediastinum. It has 4 chambers – 2 atria (Left Atrium & Right Atrium) & 2 ventricles (Left Ventricle & Right Ventricle) and has valves which maintain one-way flow of blood. There are 2 Atrioventricular valves (between the atria & ventricle) called the Bicuspid (Mitral valve) on the left side & Tricuspid valve on the right. There are two semi-lunar valves between the aorta & left ventricle (Aortic valve) & between the right ventricle & pulmonary artery. A well known & special feature of heart is the Electrical conductivity which keeps the heart beating. The superior & inferior vena cava empty blood into heart & from there it is sent to lungs for purification. Pulmonary veins bring oxygenated blood to heart. The aorta circulates this blood all throughout the body & the coronary arteries supply the heart.

In various day-to-day contexts, the word “heart” is used to signify personality, the emotional & moral nature, courage, enthusiasm, affection etc. On a lighter note, even a game of cards may be implied ! It is also a term which symbolises the “centre” of everything. To learn by-heart is often used to imply mugging up. CVDs refer to the disease affecting the heart & the blood vessels.

Hrudaya & Hrudroga

Ayurveda depicts Hrudaya in anatomical, physiological & psychological planes.
1. Anatomically, it is described as a muscular organ which resembles a (red) lotus facing downwards.
a. Location: at the centre of the chest, in between the breasts & at the entrance of stomach.
b. Adjacent organs : right lung & liver; left lung & spleen.
c. Prana Vata – is Hrudayadharaka – that which supports. It is a type of Vata which is situated in the head, moves up & down the throat & chest. It regulates breathing, sustains intellect, Hrudaya itself, sense organs & the Manas.
d. From the Hrudaya arise the 10 Dhamanis.

2. Physiologically, Hrudaya is the abode of Vyana Vata, Sadhaka Pitta, Avalambaka Kapha, Ojas & Rasa Dhatu. From Hrudaya originate the Rasavaha & Pranavaha Srotas.

a. Vyana Vata – Hrudaya takes part in circulation by this Vata. It is one among 5 types of Vata. It is situated in the Hrudaya & moves throughout the body, & is responsible for Gati (all movements – internal & external) in general, Apakshepa (movement away from the body), Utkshepa (lifting / movement towards the body), Nimesha (closing of eyes), Unmesha (opening of eyes) etc in particular.
b. Sadhaka Pitta – It is a type of Pitta present in the Hrudaya. It is responsible for intellect, decisiveness & self awareness (ego). Where there is Sadhaka Pitta (will), there is a way!
c. Avalambaka Kapha – it is a type of Kapha located in the chest which nourishes the Hrudaya by regulating supply of nutrients amongst other actions.
d. Ojas – the finest essence of all Dhatus, which remains after constant refinement. It is responsible for both physical & psychological nourishment. Its decrease will lead to fear & anxiety, loss of appetite & enthusiasm etc.
e. Rasa Dhatu – the end product of digestion ready for absorption, after separation of wastes. This carries the nutritional supply to all parts of body.
f. Rasavaha Srotas – channels which carry the digested micronutrients (Rasa Dhatu) for tissue absorption through blood stream. This describes the role of Hrudaya in macro & micro circulation. The inadequate absorption of nutrients leads to Pandu roga which is generally  correlated to Anaemia arising due to deficiencies.
g. Pranavaha Srotas – channels which carry Vata, affliction of these leads to difficulty in breathing & other respiratory distress symptoms. Indicates the role of Hrudaya in respiration.

3. Psychologically, Hrudaya is the sthana of Manas. Chinta (stress / tension) is said to be the cardinal cause of Rasa Dhatu vitiation giving rise to different disorders like Pandu roga & consequently, Hrudroga.

4. Embryologically, the Hrudaya becomes fully developed & apparent during the 4th month of pregnancy.

5. It is “Pranaadhaaraka” (abode of Life force / Prana), death equals the end of working of Hrudaya. Hence it is one amongst the 10 Marma (vital points) falling under the category of “Sadyo-praanahara” which means that any disorder of the Hrudaya can quickly turn fatal.

Author : Dr. Spoorthy S Naik, B.A.M.S
Fellowship student, Prakruthi Ayurveda Prathishtana ®,
Kuvempunagara, Mysore – 570023