HRIDROGA AND HRIDSHOOLA

1.      🫀 HRIDROGA AND HRIDSHOOLA  🫀

• HRIDROGA refers to diseases affecting the Hridya (heart region) due to vitiation of doshas, leading to structural and functional impairments.
• HRIDSHOOLA is characterized by pain or discomfort in the Hridpradesha, often a presenting symptom of various heart conditions.

ETIOLOGY (NIDANA)

• Ati Snigdha, Guru, Abhishyandi Aahara
• Krodha, Bhaya, Shoka, Vega Dharana
• Kapha-Vata prakopaka aahara-vihara
• Agantuja hetus (trauma, poison)

Reference:
चरकसंहिता, चि. 26/83
"हृदयशूलज्वरच्छर्दिवेष्टनोदाविबन्धकाः।
मर्मास्ते हृदि संगृह्णन् हृद्रोगा जातलक्षणाः॥"

PATHOGENESIS (SAMPRAPTI)

• Dosha dushti: Predominantly Vata-Kapha or Tridosha
• Dhamani and Hridya marma affected
• Srotorodha due to Meda, Kapha, Ama
• Rasa and Rakta dhatu dushti
• Hridaya’s natural gati becomes impaired → chest pain, dyspnea, fainting

SAMPRAPTI VIGHATANA (BREAKING THE PATHOGENESIS)

• Nirharana of Srotorodha (Ama, Kapha, Meda)
• Deepana-Pachana to restore Agni
• Dosha Shamana to restore balance
• Rasayana to nourish Rasa-Rakta dhatus
• Hridaya-specific Medhya-hridya drugs

TYPES OF HRIDROGA (ASHTANGA HRIDAYA & SUSHRUTA)

• VATAJA HRIDROGA – Ruja, Sosha, Spandana
• PITTAJA HRIDROGA – Daha, Sweda, Klama
• KAPHAJA HRIDROGA – Guruta, Staimitya
• SANNIPATAJA HRIDROGA – Features of all doshas
• KRIMIJA HRIDROGA – Caused by internal parasites

Reference:
अष्टाङ्गहृदयम्, उत्तरतन्त्र 3/9–13
"सन्तापो हृद्रुजो वेपथुर्विभ्रमश्चेष्टनावृतिः।
क्लमोऽनिलानिलाभ्यासात्पित्ताद्दाहः सदा ज्वरः॥"

CLINICAL FEATURES

• Chest pain or tightness (Hridshoola)
• Palpitation (Hridayaspandana)
• Dyspnea, fatigue, fainting
• Dizziness, anxiety
• In severe cases – cyanosis, edema

AYURVEDIC CHIKITSA

• VATAJA HRIDROGA
– Snehana, Swedana, Basti
– Arjuna ksheerapaka, Dashamoola
– Yogas: Hridrogahara Kashaya, Ashwagandhadi Churna

• PITTAJA HRIDROGA
– Tikta, Sheeta dravyas
– Drugs: Usheera, Chandana, Amalaki
– Yogas: Pravala Pishti, Mukta Pishti, Saraswata Ghrita

• KAPHAJA HRIDROGA
– Langhana, Vamana, Kaphahara Chikitsa
– Yogas: Trikatu, Vasa Haritaki, Dashamoola Kwatha

• SANNIPATAJA HRIDROGA
– Tridoshaghna therapy
– Rasayana like Abhraka Bhasma, Arjuna Rasayana

• KRIMIJA HRIDROGA
– Krimighna dravyas: Vidanga, Ajamoda
– Virechana, Basti, Nasya if needed

HRIDYA MAHAUSHADHIS (CLASSICAL)

• Arjuna (Terminalia arjuna) – Ksheerapaka is best
• Pushkaramoola – Vata-Kapha hara, Shwasahara
• Guduchi, Amalaki, Yashtimadhu – Rasayana
• Prabhakar Vati, Hridayarnava Rasa, Swarna Makshika Bhasma

SHLOKA – ARJUNA MAHIMA:
भवति हृद्रोगहरः श्लेष्मवातहरः परः।
कषायो रक्तशुद्धिश्च यः स्यादर्जुनसञ्ज्ञितः॥
(भैषज्य रत्नावली – हृद्रोगाधिकार)

MODERN MEDICINE CORRELATION – ISCHEMIC HEART DISEASE (IHD) & ANGINA (CHEST PAIN)

• Etiology:
– Atherosclerosis, Hypertension, Diabetes
– Hyperlipidemia, Smoking, Sedentary lifestyle

• Clinical Features (Hridshoola):
– Retrosternal chest pain, radiating to jaw/left arm
– Dyspnea, sweating, nausea
– Associated with exertion or stress

• Investigations:
– ECG, Echocardiography
– Lipid profile, Troponin
– Angiography

• Management:
– Antiplatelets (Aspirin), Statins
– Nitroglycerin for angina
– Beta blockers, ACE inhibitors
– Coronary intervention if indicated

RASAYANA & PREVENTION IN AYURVEDA

• Ojasvardhaka Rasayanas:
– Arjunarishta, Draksharishta
– Amalaki Rasayana, Chyawanprasha
– Swarna Bhasma (microdose)

• Lifestyle Practices:
– Daily abhyanga, stress management (meditation)
– Avoiding guru-snigdha ahara
– Light exercise, pranayama, yoga

• Pathya-Apathya:
– Pathya: Mudga, Shali rice, Dashamoola soup
– Apathya: Curd, red meat, excess salt, stress