Introduction – Understanding Angina Pectoris

Angina Pectoris is a clinical manifestation of myocardial ischemia—an insufficiency of oxygenated blood reaching the heart muscle. This condition leads to chest discomfort, heaviness, or tightness that typically occurs during exertion or emotional stress. While it is not a disease itself, Angina is a warning signal of underlying coronary artery disease (CAD), where the arteries supplying the heart become narrowed due to atherosclerotic plaque buildup.

In Ayurveda, such cardiac distress is understood under the broad term Hridroga—diseases of the heart. The Hridaya (heart) is described as the seat of Ojas (vital energy), Prana (life force), and Chetana (consciousness). When Doshas—especially Vata and Kapha—obstruct the flow of Prana Vayu and Rakta Dhatu within the heart channels (Rasa-Rakta Vaha Srotas), the person experiences pain, pressure, and discomfort in the cardiac region.

Ayurveda approaches Angina not merely as a symptom of blocked arteries but as a systemic imbalance resulting from poor digestion, stress, and impaired circulation of vital energies.

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Causes of Angina Pectoris (Hetu)

Modern medicine attributes Angina primarily to coronary artery narrowing, but Ayurveda expands the understanding to deeper systemic disturbances that originate in faulty metabolism (Agni Mandya), poor diet, and lifestyle errors.

1. Atherosclerosis and Blockages:

The most common cause is atherosclerosis—plaque buildup inside the coronary arteries, leading to reduced oxygen delivery to the heart muscles.

2. Vata and Kapha Imbalance:

Vata dosha governs circulation, movement, and nerve impulses, while Kapha governs structure and lubrication. When Vata becomes aggravated and Kapha thickens within the arteries, the channels become constricted, resulting in impaired flow of Prana and Rakta.

3. Unhealthy Diet (Ahara):

Consumption of heavy, oily, fried, processed foods, excess salt, refined sugar, and alcohol lead to Ama (toxins) and blockages within the Srotas (channels).

4. Sedentary Lifestyle (Vihara):

Lack of exercise, improper sleep, smoking, and chronic stress elevate cholesterol, increase blood pressure, and weaken Ojas, directly affecting heart vitality.

5. Mental Stress (Manasika Nidana):

Emotional disturbances such as anxiety, grief, anger, and chronic worry disturb Prana Vayu and Sadhaka Pitta—both vital energies related to the heart and mind. Persistent mental strain is one of the strongest causative factors.

6. Metabolic Disorders:

Diabetes, hypertension, and obesity accelerate arterial degeneration and contribute to ischemic heart disease.

7. Genetic and Age Factors:

Individuals with a family history of heart disease or those in middle to late age are more prone due to natural weakening of Agni and Dhatu (tissues).

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Signs & Symptoms of Angina Pectoris

The hallmark symptom of Angina is chest pain or discomfort that arises due to temporary oxygen deprivation of the cardiac muscles. Ayurveda notes pain as a manifestation of Vata, while heaviness and tightness indicate Kapha obstruction.

Major Symptoms Include:

Pain, tightness, or squeezing sensation in the chest (often behind the sternum).

Radiation of pain to the shoulders, arms, neck, jaw, or back.

Breathlessness or shortness of breath during exertion or stress.

Fatigue, dizziness, or lightheadedness.

Excessive sweating and feeling of heaviness in the chest.

Palpitations or irregular heartbeat.

Nausea or indigestion-like symptoms.

The discomfort typically lasts a few minutes and is relieved by rest or medication like nitroglycerin. Ayurveda recognizes similar pain patterns in Vataja Hridroga (painful due to obstruction and dryness) and Kaphaja Hridroga (pain due to heaviness and congestion).

Persistent or worsening pain may suggest unstable angina or impending heart attack, requiring urgent medical attention.

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Diagnostic Methods for Angina Pectoris

Accurate diagnosis is crucial to differentiate Angina from other causes of chest pain. Ayurveda emphasizes both classical diagnostic tools and modern investigations for comprehensive evaluation.

Modern Diagnostic Methods:

1. Electrocardiogram (ECG): Detects changes in electrical activity of the heart during ischemic episodes.

2. Echocardiography: Assesses heart function, wall motion, and ejection fraction.

3. Stress Test (TMT): Evaluates the heart’s response to exercise and identifies ischemic patterns.

4. Coronary Angiography: Visualizes the coronary arteries to locate blockages or narrowing.

5. Blood Tests: Lipid profile, troponin levels, and blood sugar to assess risk factors.

Ayurvedic Diagnostic View:

1. Darshana (Observation): Facial complexion, body build, pulse pattern, and signs of anxiety or restlessness are noted.

2. Sparshana (Touch): Nadi Pariksha helps in identifying Vata-Kapha dominance and irregular pulse patterns.

3. Prashna (Inquiry): The practitioner assesses dietary habits, mental stress, digestion, and emotional tendencies.

4. Agni and Ojas Evaluation: Weak Agni leads to Ama formation, while depleted Ojas reduces cardiac resilience.

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Angina Pectoris – Ayurvedic View

In Ayurveda, Angina Pectoris is categorized under Hridroga—diseases of the heart. The Hridaya is regarded as a Marma (vital organ) and the seat of Ojas, Prana Vayu, and Sadhaka Pitta. Disturbance in these entities results in pain, weakness, and emotional instability.

Types of Hridroga:

1. Vataja Hridroga: Caused by aggravated Vata leading to constrictive pain, palpitation, and dry nature.

2. Kaphaja Hridroga: Heaviness, stiffness, and congestion due to phlegmatic accumulation.

3. Pittaja Hridroga: Burning sensation, feverishness, and irritability caused by excess Pitta.

4. Sannipataja Hridroga: Combination of all three doshas, resulting in complex cardiac dysfunction.

Pathogenesis (Samprapti):

Improper digestion → formation of Ama.

Ama mixes with Kapha → thickens arterial channels.

Vata disturbs circulation → obstruction and chest pain.

Ojas gets depleted → weakens cardiac muscle and emotional stability.

Ayurveda aims to restore balance by pacifying Vata, clearing Kapha, and strengthening Ojas through diet, herbal formulations, and rejuvenation therapies like Hridaya Basti, Abhyanga, and Nasya.

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Herbal Remedies for Angina Pectoris

Ayurvedic herbs work holistically to strengthen cardiac muscles, improve blood circulation, lower cholesterol, and calm the mind.

1. Arjuna (Terminalia arjuna):

The most revered cardiac tonic in Ayurveda. It strengthens heart muscles, improves oxygenation, and reduces chest pain.

2. Pushkarmool (Inula racemosa):

An excellent Hridya herb that improves circulation and relieves breathlessness.

3. Guggul (Commiphora mukul):

Reduces cholesterol and cleanses arterial blockages.

4. Shankhpushpi (Convolvulus pluricaulis):

Calms mental stress and anxiety linked to cardiac pain.

5. Brahmi (Bacopa monnieri):

Stabilizes heart rhythm by calming the nervous system.

6. Jatamansi (Nardostachys jatamansi):

Regulates heart rate and reduces oxidative stress.

7. Yashtimadhu (Glycyrrhiza glabra):

Provides anti-inflammatory and antioxidant support.

8. Garlic (Lashuna):

Improves circulation and prevents plaque buildup.

9. Triphala & Trikatu:

Aid digestion, reduce Ama, and enhance nutrient absorption for cardiac nourishment.

Regular practice of Pranayama (especially Anulom Vilom and Bhramari), yoga, meditation, and consumption of heart-strengthening rasayanas like Arjunarishta and Dashmoolarishta further enhances recovery and prevention.

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Conclusion

Angina Pectoris is not merely a disorder of the arteries but a reflection of deeper imbalances in the mind-body system. Ayurveda, through its comprehensive understanding of Doshas, Agni, and Ojas, provides a timeless path to restore cardiac balance.
Through Raseshwar Herbal’s authentic Ayurvedic formulations, dietary moderation, and rejuvenative therapies, one can not only relieve chest discomfort but nurture the heart—physically, emotionally, and spiritually.