Author: Dr. Vikram Chauhan

Abstract

Mitral valve prolapse is a type of heart valve disease that affects the valve between the left heart chambers. Heart disease develops when the arteries that supply blood to the heart become clogged with plaque and cause them to harden and narrow. Other kinds of heart problems when the heart may not pump enough blood causes heart failure. Some may have signs of indigestion, exercise intolerance that can not perform activity normally. In heart disease it doesn’t get enough blood supply to provide oxygen to the muscles especially during exercise. When coronary arteries get blocked due to plaque it ruptures and causes clot then blood supply of the heart is lost causing heart muscles to die. In this disease we are going to discuss its signs, symptoms, treatment and its ayurvedic aspect in detail.

Introduction

Myxomatous mitral disease is the most common form of valvular heart disease. The flaps of the mitral valve are floppy which bulge backwards into the heart’s left upper chamber when the heart squeezes. When this prolapse causes blood to leak backwards developing a condition known as mitral valve regurgitation. It is commonly known as Barlow syndrome, Click murmur syndrome, Floppy disease, Billowing mitral valve syndrome. It is a common disease which is completely harmless.

The mitral valve is the door that connects the left atrium to the left ventricle, and these chambers are responsible for collecting oxygen rich blood and then pumping to the whole body. The leaflets are responsible for opening and shutting with each heartbeat to manage blood flow. But in this disease there is abnormality in leaflets and chordae causing the valve floppiness which causes mitral valve prolapse. Myxomatous is usually benign but complications include endocarditis, chordal rupture. Some patients experience chest pain, dyspnea, dizziness, and include crisp mid systolic which is followed by late systolic murmur if regurgitation is present.   

FACTS

• Heart is the leading cause of death.
• One person dies every 34 seconds in United states from cardiovascular disease
• Mitral valve prolapse is caused due to weakness in the tissue.
• If mitral valve leaflets do not form tight seals upon closure it causes heart valve disease.
• Mitral valve prolapse causes 2 conditions – Mitral valve stenosis and Mitral valve regurgitation.
• Women above 50 year of age should be careful as they are more prone to develop this disease.
• Two distinct sounds can detect mitral valve prolapse
• Heart attacks and rheumatic can further damage mitral valve leaflets.

CAUSES

1. When there is bulging of the valve blood leaks backwards causing mitral valve regurgitation.
2.  Mitral valve prolapse is caused by valve tissue weakness called myxomatous degeneration.
3. Marfan syndrome – is an inherited disorder that affects connective tissue, fibres which support organs and other structure of the body. Most commonly affects the heart, eyes, and blood vessels.
4. Loeys Dietz syndrome- is a connective tissue disorder with hypertelorism (widely spaced eye), bifid uvula.

SYMPTOMS

• Irregular heart beat
• Dizziness
• Fatigue
• Shortness of breath during exercise and lying down
• Chest pain
• Migraines
• Orthostatic hypotension (BP falls down when patient stands up)
• Syncope
• Benign arrhythmias (atrial premature beats)
• Ventricular premature beats

DIAGNOSIS

1. Echocardiography
2. Transthoracic echocardiogram
3. Transeseophageal echocardiogram
4. Chest X ray
5. Cardiac catheterization
6. Exercise and stress test

PROGNOSIS

1. It is usually benign but myxomatous degeneration of the valve leads to MR.
2.  In patients with severe MR there is incidence of left atrial enlargement, arrhythmias (atrial fibrillation), stroke, endocarditis, stroke which further need for valve replacement.

TREATMENT

• Sometimes patients don’t need any treatment for mitral valve prolapse but in mild form beta blockers are prescribed. As beta blockers relax the vessels and slow down heart rate.
• In atrial fibrillation anticoagulants (blood thinners) are given, as in atrial fibrillation there is a risk of blood clots and strokes.
• Antibiotics are given to prevent heart infection known as infective endocarditis.
• Diuretics to remove salt and water through urine and reduce blood pressure.
• Antiarrhythmics are given to reduce the irregular heart rhythms.
• In mitral valve prolapse two surgery are done

Mitral valve repair the surgeons take out the excess tissue from the valve which is prolapsed so that flaps can be closed tightly. Cords are also removed to support the valves.

Mitral valve replacement is done when mitral valve repair is not possible. In this surgery the mitral valve is removed and replaced with a mechanical valve made from cow, pig heart. Sometimes a heart catheter is also done to place a replacement valve into a biological valve which is known as valve in valve procedure.

Replacement and repair surgery are often open surgery techniques which are minimally invasive and percutaneous.

PREVENTION

1. Build an healthy lifestyle  and exercise daily
2. Quit tobacco and smoking
3. Heart building eating plans must be followed such as low fat and fat free dairy products, avoid taking saturated and trans fat, excess salt and sugar.
4. Maintain a healthy weight
5. Blood pressure and diabetes must be in control
6. Manage stress by practicing Yoga and medication.

AYURVEDIC MANAGEMENT

Hrid roga means cardiac disorder, due to change in diet and style the incidence of heart disorder is increasing day by day. Ayurveda is serving society by cure and prevention (swasthya rakshanam) to prevent heart disease. To assess ahara, dincharya, vihara, ritucharya, rasayan is described to play an important role in heart diseases. According to Acharya Sushrutha suppression of natural urge, intake of ushana, rukshana, moves to hridya which involves rakta. In this disease due to intake of mithya ahara vihara agnimandya is caused which further causes saam rasa dhatu (hypercholesterolemia) and due to sama rasa dhatu sroto avrodh and dhamniparticharya (Atherosclerosis, obstruction of arteries) occurs which further results in hridya rogas.

NIDANA

1. Consumption of hot food
2. Excessive consumption of sour, astringent, bitter food.
3. Excessive thinking, stress.
4. Forcefully withhold natural urge
5. Administration of excessive purgation therapy
6. Frequent vomiting
7. Over anxiety
8. Excessive ama formation

SAMANYA LAKSHANA

1. Discoloration
2. Cough
3. Tastelessness
4. Abdominal pain
5. Abnormal tastes in the mouth
6. Dyspnea
7. Hiccough
8. Thirst

TYPES OF HRID ROGAS

1. Vataja hrid rogas–  Heart disease caused by vitiated vata doshas causing

1. Expansion of heart
2. Blasting pain in heart
3. Cutting pain
4. Pricking type of pain

2. Pittaja hrid rogas – Heart diseases caused by vitiated pitta dosha-

1. Severe thirst
2. Burning sensation
3. Excessive tiredness
4. Excessive sweating
5. Dryness of the oral cavity
6. Sucking pian

3. Kaphaja hrid rogas- Heart disease caused by vitiated kapha

1. Heaviness in the body
2. Tastelessness
3. Sweet taste in the mouth
4. Rigidity
5. Anorexia
6. Excessive salivation

4. Tridosha hrid rogas– Here all the symptoms of doshas are present

5. Krimija hrid rogas– In krimija hrid rogas the person who is consuming excess dugdha (milk), jaggery while having hrid rogas a cystic swelling is formed in hridaya marma. The granthi gets filled up with kleda (exudates) the rasa dhatu moves in circulation and increases exudates which becomes an ideal environment for krimi to manifest by consuming incompatible food in the heart due to development of krimi. It can be correlated with myocardial infarction

• Nausea
• Excessive spitting
• Pricking pain
• Colic chest pain
• Blackish discoloration of eye
• Anorexia

COMPLICATION

• Giddiness
• Cough
• Dryness of throat
• Psychological disorders
• Epilepsy, memory related disorders
• Tissue depletion
• Dryness of palate
• Destruction of mind
• Delirium (serious disturbance in mental abilities result in confused thinking and reduced awareness).

TREATMENT OF HRID ROGAS

• Avoidance of manas hetu
• Diet and style modification
• Rasayan therapy for hriday rog – amalaki rasayan, shilajeet rasayan.
• Nidan parivarjan – change in diet and life style habit
• Samshodhana therapy- is a purification therapy which removes the toxins (vitiated by doshas, dhatus) and causes disease. It restores the equilibrium of doshas. It is known as five fold line of treatment

There are 3 stages

1. Purva karma- snehan, sweden
2. Pradhan karma- vaman, virechan, asthapana basti, anuvasana basti, nasya karma.
3. Paschat karma- post purification therapy.

Mridu vamana in vata and kapha hridrogas.

Virechana in krimij hrid rogas.

Snehan, sweden, shirodhara is also effective in heart disease

Yoga for hrid roga

1. Light exercise
2. Shavasan
3. Surya namaskar
4. Pranayam

HERBS USEFUL IN HRID ROGAS-

1. ARJUNA

Arjuna (Terminalia arjuna) is useful for anginal pain, congestive heart failure, dyslipidemia. It has antioxidant cardiovascular properties. It has kashaya rasa (astringent taste) that acts as stambhana and heals fracture wounds quickly. It is useful in relieving ulcers due to pitta and kapha doshas, and relieves thirst and fatigue. Arjuna is a cardiac tonic that strengthens the heart and high cholesterol.

2. Pushkar

Pushkar (Inula racemosa) useful in treatment of heart disease, asthma, cough. Because of its bitter taste it balances kapha dosha and due to its hot potency it balances vata dosha. Pushkar is useful in fever, flank pain, COPD, has antihistamine and bronchodilator effects. It acts as a beta blocker herb so it is very useful in high BP. It has antiviral and antibacterial effects and is a uterine stimulant

HERBAL REMEDIES BY PLANET AYURVEDA FOR MYXOMATOUS MITRAL VALVE DISEASE

Planet ayurveda is an ayurvedic clinic which provides great treatment with many great results. All the formulations are made under the strict guidance of M.D experts. These remedies are free from any kind of color, resins, and preservatives. The formulations are free from any side effect as they are 100% pure medications made by natural products such as plant extract. No animal product is used in making any formulation  which provides great relief to patients without any side effects. Planet Ayurveda provides HEART CARE PACK which is useful in heart disease .

PRODUCTS LIST

1. Arjuna Capsules
2. Arjun Tea
3. Total Heart Support
4. Gotu Kola Capsules.

PRODUCTS DESCRIPTION

1. ARJUNA CAPSULES

These capsules are single herbal preparation formulated by planet ayurveda using standardized extract of Arjuna (Terminalia arjuna). Arjuna capsules balance all the three doshas in the body, maintaining a healthy heart and healthy blood cells. It decreases LDL level and is an excellent antioxidant. It is used as cardiac tonic which has cold potency, astringent taste (kashaya), laghu guna (lightness). Regular intake of these capsules maintains a healthy heart without any side effects.

Dosage- 1-2 capsules twice daily with plain water after meals.

2. ARJUN TEA

Arjun tea is a herbal tea preparation formulated by planet ayurveda using ingredients like Arjuna (Terminalia arjuna), Punarnava (Boerhavia diffusa), Choti elaichi (Elettaria cardamomum) and many more. It is very effective in heart disease which is helpful in coronary artery blockage, disturbed cholesterol level, rich in antioxidants, provides nutrition to heart and strengthens the heart muscles

Dosage- One cup daily

3. TOTAL HEART SUPPORT

Total heart support capsules are poly herbal capsule formulated by planet ayurveda using ingredients like- Arjuna (Terminalia arjuna), Ashwagandha (Withania somnifera), Shankhpushpi (Convolvulus pluricaulis), Brahmi (Bacopa monnieri). These capsules are effective in congestive heart failure and give strength to failing heart muscles. Ashwagandha helps to calm down the nerves and strengthen them by providing nutrition.

Dosage– 1-2 capsules twice daily with plain water after meals.

4. Gotu Kola Capsules

Gotu kola capsules are single herbal capsules formulated by planet ayurveda using standardized extract of Gotu Kola (Centella asiatica). It improves the heart condition such as atherosclerosis, myocardial ischemia which improves blood circulation. It helps to improve tridosha in a balanced state, managing cardiac debility, odema.

Dosage- 1-2 capsules twice daily with plain water after meals.    

CONCLUSION

Mitral valve prolapse is a type of heart valve disease that affects the valve between the left heart chambers. It is commonly known as Barlow syndrome, Click murmur syndrome, Floppy disease, Billowing mitral valve syndrome. Myxomatous is usually benign but complications include endocarditis, chordal rupture. Hrid roga means cardiac disorder, due to change in diet and style the incidence of heart disorder is increasing day by day

Ayurveda is serving society by cure and prevention (swasthya rakshanam) to prevent heart disease. As we discussed above in the topic,  planet Ayurveda prepared HEART CARE PACK which is effective in all types of  heart diseases which provides a good and healthy heart to one being without causing any side effects.