This document summarizes three cardiac case studies treated through Ayurveda. The first case involves a 46-year-old male engineer with a history of heart disease and stenting who received panchakarma treatments and herbal medications. The second case is a 62-year-old male contractor who presented with chest pain and underwent angiography showing coronary artery disease, receiving similar treatment. The third case involves a 39-year-old laborer with chest pain found to have coronary artery disease on tests who was also treated with panchakarma and herbal remedies.

1. Cardiac case management through Ayurveda
By-
Prof.Dr. S. N. Ojha
Director, Principal
Ashta Ayurveda college and Hospital
Sangli

2. CASE 1

3. PATIENT DETAILS
NAME: XYZ
AGE: `46 years
SEX: Male
OCCUPATION: Engineer
Date : 10-02-18
ADDRESS: Goa
OPD No.: KLE 18002469

4. CHIEF COMPLAINTS
 Patient approached Hridya OPD on 10/02/2018 for the
purpose of improvement in Cardiac health
 Patient is asymptomatic
 No any signs or symptoms related to heart disease were
observed
 k/c/o – DM - since 3 years
HTN - since 3 years
 h/o – PTCA and Stenting 3 times

5. HISTORY OF PRESENT ILLNESS
 On 20-10-2015 the patient developed sudden onset of severe
chest pain radiating to throat, jaw, left shoulder for which he
consulted in Goa medical college and hospital, Goa
 CPK MB and CPK total were 10 times higher
 Diagnosed as Acute Anterior wall MI
 Coronary angiography done and revealed 95% stenosis in mid
LAD, 85% stenosis in proximal and mid RCA
 Emergency angioplasty with stent to LAD was done

6. Lab reports
CPK MB – 290 U/L
CPK Total – 3334 U/L
Troponin T - Positive

7. Echocardiograhy 20-10-15

8. Coronary Angiography 20-10-15

9. On discharge -
 Tab. Deplat 150 mg 1 od
 Tab. Ecospirin 75 mg 1 od
 Tab.Storvas 80 mg 1 od
 Tab.Cardivas 3.125 mg 1 od
 Tab. Flavadon MR 35 1 bd
 Tab. Janumet 50/500 mg 1 od
 Tab. Pan D 1 od

10. 02 years later

11. Cont..
 20-03-2017, the patient developed pain in chest and jaw, chocking
sensation and weakness in both lower limbs
 He consulted in Manipal hospital, Goa.
 CKMB - normal
 Angiography done and revealed 90% stenosis in LAD, 90%
stenosis in mid RCA, 70% stenosis in OM1 of left circumflex artery
 patient was subjected to PTCA and stent to LAD and RCA.

12. Coronary Angiography 20-03-17

13. PTCA report

14. On discharge -
 Tab. Deplat 150 mg 1 od
 Tab. Ecospirin 75 mg 1 od
 Tab.Storvas 80 mg 1 od
 Tab.Cardivas 3.125 mg 1 od
 Tab. Flavadon MR 35 1 bd
 Tab. Janumet 50/500 mg 1 od
 Tab. Pan D 1 od

15. 10 months later

16. Cont..
 On 12-01-2018 the patient again had discomfort in throat and
associated pain, dyspnea, epigastric discomfort, and vomiting.
 He was subjected to Coronary angiography which revealed Left
circumflex artery proximal and distal 40-50% stenosis, OM1 – 70%
stenosis and its branch 90% stenosis, LAD
(proximal)40% stenosis
 patient underwent PTCA and stent to OM .

17. Echocardiograhy 13-1-18

18. Coronary Angiography 16-1-18

19. PTCA + Stenting

20.  Appetite: good
 Bowels: regular, once/day, bit hard
 Micturation: normal
 Sleep: sound
 Habits : no smoking, no alcohol
 Work stress since 2005
 Diet : rich in non-veg (mutton), chinese chicken soup in college days
Fried fish 3 times / week since he started job
 Exercise : walking, jogging, few gym exercises upto 2010
after 2010 he reduced physical activity
PERSONAL HISTORY

21.  Pallor: No
 Icterus: Absent
 Cynosis: Absent
 Lymph nodes: no lymphadenopathy
 Pulse: 72 / bpm
 Temperature: Normal
 B.P: 102 / 70 mm of Hg
GENERAL EXAMINATION

22.  CVS: S1, S2 Heard
no added sounds
HR – 72 / min
BP – 102 / 70 mm Hg
 CNS: Conscious, well oriented
 R/S: Airway entry normal bilaterally, clear
 P/A: Soft, non tender
Systemic examination

23. INVESTIGATIONS
 Cholesterol - 111 mg/dl
 HDL Cholesterol - 36.9 mg/dl
 LDL Cholesterol - 63.1 mg/dl
 VLDL Cholesterol - 21 mg/dl
 Triglycerides – 114 mg/dl
 Cholesterol / HDL Cholesterol ratio – 2.7 mg/dl
 Bl urea – 17 mg/dl
 Sr. creatinine – 0.8 mg/dl
 HbA1c – 7.2 %

24. Echo
cardiograhy
10-02-18

25.  Coronary artery disease
 Tridoshaja Hridroga
VYADHI VINISCHAYA

26. Samprapti ghataka
 Dosha – Kapha, pitta, vata
 Dushya – Rasa, shonita, mamsa, meda
 Srotas – rasavaha, raktavaha, medavaha
 Srotodushti prakara – sanga
 Agni – samagni
 Ama – dhatwagni mandyajanya
 Udbhava sthana – Amashaya
 Vyakta sthana – Hridaya, dhamani

27. Dashavidha pareeksha
 Prakruti –Pitta, Kapha
 Sara – madhyama
 Samhanana – madhyama
 Satva - madhyama
 Satmya – sarvarasa satmya
 Samhanana - madhyama
 Ahara shakti – Jarana shakti – prakruta
 Abhyavarana shakti - prakruta
 Vyayama shakti - madhyama
 Vaya - madhya

28. 10/02/18
 Hrid dashamuladi cap 2 bd
 Hrid abrakadi cap 1bd
 Hrid chatushparynadi cap 2bd
 Shatavari churna - 45 grms
+ Shalaparni churna -15gms
+ Shunti churna - 4gms
½ tsf od bf
CHIKITSA

29. Hrida dashmooladi
Name of the Ingredients
 DASHMOOLA
 ERANDMOOLA
 PUSHKARMOOLA
 DEVADARU
 HARITAKI
 AMALAKI
 AMRUITA
 KAMALA
 VACHA
 CHITRAKA
 SHUNTI
 MARICHA
 PIPPALI

30. Hridya Abhrakadi
 Shringa bhasma
 Abhraka bhasma
 Loha bhasma
 Tamra bhasma
 Pushkaramoola(Inula racemosa)
 Devadaru (Cedrus deodara)
 Rasna (Pluchea lancelolata)
 Erandamoola (Ricinus communis)
 Haritaki (Terminalia chebula)
 Trikatu
 Vacha (Acorus calamus)

31. Hrida chatushparnyadi
 Shalaparni
 Mudgaparni
 Mashaparni
 Prishnaparni

32. 25/02/18
 Kosta shodana with gandarvahastadi castroil 30ml
+ ksheera 60ml
 Hridaya parisheka with dashamula kashaya
 Hridaya basti with sahacharadi taila
 Basti karma
 Matra basti with Manistadi taila – 30 ml
 Niruha basti (Hridroga prakarana)- kala basti pattern

33. 27/2 28/2 01/3 02/3 04/3 05/3 06/3 07/3 08/3
- NB NB - NB NB NB NB -
MB MB - MB MB MB MB MB MB

34. On discharge 08-3-18
 Shatavari churna - 45 grms
+ Shalaparni churna - 15gms
+ Shunti churna - 4gms
½ tsf od bf
 Hrid dashamuladi cap 2 bd
 Hrid abrakadi cap 1bd
 Hrid chatushparynadi cap 2bd
 Kamadugha with mukta 1 od
for 1 ½ months

35. 21-4-18
 Shatavari churna - 45 grms
+ Shalaparni churna - 15gms
+ Shunti churna - 4gms
½ tsf od bf
 Hrid dashamuladi cap 2 bd
 Hrid abrakadi cap 1bd
 Hrid chatushparynadi cap 2bd
 Kamadugha with mukta 1 od

36. Echo
cardiograhy
18-05-18

37. Echo
cardiograhy
12-10-18

38. TMT

39. CASE 2

40. PATIENT DETAILS
 NAME: XYZ
 AGE: `62 years
 SEX: Male
 OCCUPATION: retd contractor
 Date : 09-06-18
 ADDRESS: Belagavi
 OPD No.: KLE 18009947

41. CHIEF COMPLAINTS
 Chest pain – left sided
 Frequency of chest pain is once in two days
 Exertional dyspnoea – on walking upto 500 meters
on climbing one stair
 Chest heaviness
since 4 months

42.  K/C/O – Diabetes mellitus on Insulin
 Family h/o – Cardiac disease present
 Brother suffering with CAD

43.  Appetite: good
 Bowels: regular, once/day
 Micturation: normal
 Sleep: sound
 Habits : Chronic Smoking
 Alcohol consumption 2 times / week
 Work stress since 2010
 Diet : rich in non-veg , oily diet
 Exercise : poor physical exercise
PERSONAL HISTORY

44.  Pallor: No
 Icterus: Absent
 Cynosis: Absent
 Lymph nodes: no lymphadenopathy
 Pulse: 74 / bpm
 Temperature: Normal
 B.P: 130 / 86 mm of Hg
GENERAL EXAMINATION

45.  CVS: S1, S2 Heard
no added sounds
HR – 74 / min
BP – 130 / 86 mm of Hg
 CNS: Conscious, well oriented
 R/S: basal crepts heard
 P/A: Soft, non tender
Systemic examination

46. Investigations -
ECG

47. Coronary
Angiography

48. Cont..

49.  Coronary artery disease (Unstable Angina)
 Tridoshaja Hridroga
VYADHI VINISCHAYA

50. Samprapti ghataka
 Dosha – Kapha, pitta, vata
 Dushya – Rasa, shonita, mamsa, meda
 Srotas – rasavaha, raktavaha, medavaha
 Srotodushti prakara – sanga
 Agni – samagni
 Ama – dhatwagni mandyajanya
 Udbhava sthana – Amashaya
 Vyakta sthana – Hridaya, dhamani

51. Dashavidha pareeksha
 Prakruti – Vata, kapha
 Sara – madhyama
 Samhanana – madhyama
 Satva - madhyama
 Satmya – sarvarasa satmya
 Samhanana - madhyama
 Ahara shakti – Jarana shakti – prakruta
 Abhyavarana shakti - prakruta
 Vyayama shakti - madhyama
 Vaya - madhya

52.  Hrid dashamuladi cap 2 tid
 Hrid abrakadi cap 2 bd
 Hrid chatushparynadi cap 1 bd
 Bramhmi vati 1 HS
CHIKITSA

53. Panchakarma treatments -
 Kosta shodana with gandarvahastadi castroil 30ml
+ ksheera 60ml
 Hridaya parisheka with dashamula kashaya
 Stanika abhyanga with Agaruvadi taila + Murchita taila
 Basti karma
 Anuvasana basti with Manjistadi taila – 30 ml
 Niruha basti (Hridroga prakarana)- kala basti pattern

54. On discharge -
 Hrid dashamuladi cap 2 tid
 Hrid abrakadi cap 2 bd
 Hrid chatushparynadi cap 1 bd
 Bramhi vati 1 HS

55. Follow up after 1 month
 Chest pain reduced, one / two episodes in a week
 Exertional dyspneoa reduced
 Can able to walk for 1 km
 Can climb two stairs
 No chest heaviness

56. AT - ECG

57. Echo-
cardiography

58. cont..

59. CASE 3

60. PATIENT DETAILS
 NAME: XYZ
 AGE: `39 years
 SEX: Male
 OCCUPATION: labour
 Date : 27-12-18
 ADDRESS: Belagavi
 OPD No.: KLE 1802577

61. CHIEF COMPLAINTS
 Chest pain – both sided, interscapular regions
Onset – sudden,
Frequency – 3-4 times / day
 Exertional dypsneoa
 Chest heaviness on walking for 100 – 200 mtrs

62. Personal history -
 No h/O – Diabetes mellitus / Hypertension
 No Family h/o – Cardiac disease
 Habits –
Tobacco chewing – since 10 yrs , regular
Alcohol - since 10 yrs, regular since 5 yrs
 No smoking
 Diet – mixed,
Non-veg diet regular since 06 yrs

63. Investigations –
Echo-
cardiograhy

64. Cont..

65. TMT -

66. Coronary
Angiography

67. Cont..

68.  Coronary artery disease (Unstable Angina)
 Tridoshaja Hridroga
VYADHI VINISCHAYA

69. Samprapti ghataka
 Dosha – Kapha, pitta, vata
 Dushya – Rasa, shonita, mamsa, meda
 Srotas – rasavaha, raktavaha, medavaha
 Srotodushti prakara – sanga
 Agni – samagni
 Ama – dhatwagni mandyajanya
 Udbhava sthana – Amashaya
 Vyakta sthana – Hridaya, dhamani

70. Dashavidha pareeksha
 Prakruti – Vata, Pitta
 Sara – madhyama
 Samhanana – madhyama
 Satva - madhyama
 Satmya – sarvarasa satmya
 Samhanana - madhyama
 Ahara shakti – Jarana shakti – prakruta
 Abhyavarana shakti - prakruta
 Vyayama shakti - madhyama
 Vaya - madhya

71. Panchakarma treatments -
 Kosta shodana with gandarvahastadi castroil 30ml
+ ksheera 60ml
 Hridaya parisheka with dashamula kashaya
+ Erandamoola
+ Amrita
+ haridra
 Hridaya Basti – Sahacharadi taila
 Basti karma
 Anuvasana basti with Manjistadi taila – 30 ml
 Niruha basti (Hridroga prakarana)- kala basti pattern

72. On discharge -
 Hrid dashamuladi cap 2 tid
 Hrid Chatushparnyadi cap 1 tid
 Kaishor guggulu 2 bd
 Dashamoolarishta 4 tsf bd

73. During treatment - ECG

74. AT - ECG

75. Case 4

76. Description of Patient
Name - xyz
Age – 41years
Sex – Female
Occupation – Housewife
Address – Globe area camp,Belgavi,Karnataka
Socio-economic status – middle class
OPD no –op 18005213

77. Pradhana Vedana
 Exertional dyspnea – 2yrs
 Chest pain on and off – 1 yrs
 Pain in lower limbs – 1 yrs
 Giddiness
 Eye Floaters on and off
 Lightheadedness, dizziness or fainting

78. Vedana Vrittanta
 Patient was said to be apparently healthy 4 years back. she was N/H/O HTN and DM.
 Before 4 yrs patient developed tumour like structure on neck.
 She went to Army hospital Belgavi, Blood Investigation and X ray was done. X ray was
normal but some changes seen in Heart X ray then consultant did some Investigation like
MSCT AORTOGRAM. He was diagnosed as Descending Aortic aneurysm on medication
.She took treatment for 2-3 yrs in that hospital. But no relief, symptoms persisted.
 Then patient approached to KAHERS Shri BMK Ayurvedic hospital,Belgavi in Cardiac
care unit for treatment purpose.

79. Aortogram

80. Cont..

81. Cont,,

82. PET CT

83. Cont…

84. Vaiktika Vrittanta
 Aahara – Mishrahar , rukshanna sevana
 Vihara – Shramajanya
 Nidra – Disturbed due to pain
 Kshudha – Alpa
 Purisha – vikrut , baddhata
 Mutra – prakruta
 Vyasana – Tea since 15 to 20 years .

85. General Examination
 Pallor – Absent
 Icterus – Absent
 Cyanosis – Absent
 Koilonychias– Absent
 Lymphadenopathy – Absent
 Oedema – B/L Pitting oedema Absent
 Blood Pressure – 130/80 mm Of Hg
 Respiratory Rate – 18 Cycles/Min
 Pulse Rate –84 Pulse/Min
 Weight – 62.4 Kg

86. Systemic Examination
 CNS – Conscious well oriented to place, time and person , Slurred
speech
 CVS – S1, S2 heard
 RS – AEBS
 MSK – GALS are normal
 P/A – No G/R/T
L0 S0 K0

87. Treatment Given
 HRID TIKTAKADI CAP 2BD
 HRID VASADI CAP 2BD
 HRID ARJUNADI CAP 2BD
 HRID CHATUSPRNYADI 1BD
 HRID ABHRAKADI CAP 1 BD
 SHATAVARI CHURNA 30GM
+
SHALPARNI CHURNA 15 GM
+
SHUNTHI CHURNS 5 GM ½ TSP WITH MILK OD

88. Hrid Tiktakadi
 KIRATATIKTA
 PATOLA
 AMRUTA
 AMALAKI
 HARITAKI
 VIDANGA
 CHITRAKA
 VACHA
 TRIKATU
 YASTIMADHU
 For Bhavana KAMAL
GUDUCHI

89. Hrid Vasadi
 VASA
 KANTAKARI
 YASTIMADHU
 SHIRISH
 TULASI
 VIDANGA
 GORAKMUNDI
 HARIDRA
 DARUHARIDRA
 AMALAKI
 PIPPALI
 AMRUTA
 For Bhavana - TULASI
HARIDRA
DARUHARIDRA

90. Hrid Arunadi
 SHALPARNI
 SHATAVARI
 BRAHMI
 ARJUNA
 AMALAKI
 For Bhavana - ARJUNA
AMALAKI

91. RESULTS -

92. THANK
YOU !