Summary

An enlarged heart is a symptom of an underlying disorder that is causing the heart

to work harder than normal. Another name for an enlarged heart is cardiomegaly.
Possible symptoms include breathing problems, shortness of breath, dizziness,
irregular heartbeat (arrhythmia), heart palpitations or fluid retention. An
enlarged heart may be asymptomatic (have no symptoms).

Download the PDF version of this fact sheet Email this fact sheet
The heart is a muscular pump about the size of a clenched fist. An enlarged heart
isn�t a condition in itself, but a symptom of an underlying problem that is causing
the heart to work harder than normal.

Older people are at increased risk of having an enlarged heart. Another name for an
enlarged heart is cardiomegaly.

The range of underlying problems that can lead to an enlarged heart may be:
Pathological � linked to actual disease of the heart muscle
Physiological � linked to other causes that are overworking the heart muscle, such
as high blood pressure or thyroid diseases.
Symptoms of an enlarged heart

In some cases, an enlarged heart is asymptomatic (has no symptoms).

When symptoms do occur, it may be because the heart fails to pump blood effectively
and this leads to a syndrome known as congestive heart failure. Symptoms may
include:
Breathing problems
Shortness of breath
Dizziness
Irregular heartbeat (arrhythmia)
Heart palpitations
Fluid retention.
Causes of enlarged heart

Some of the many causes of enlarged heart include:

Coronary artery disease � fatty deposits or plaques build up inside one or more of
the coronary (heart) arteries. This constant �silting� is called atherosclerosis
and it results in narrowing of the artery. This reduces the oxygen supply, which is
the fuel for the pump.
High blood pressure (hypertension) � blood pumps with more force than usual through
the arteries, which puts strain on the heart. Causes of high blood pressure include
obesity and a sedentary lifestyle.
Idiopathic dilated cardiomyopathy � disease of the heart muscle, the cause of which
is unknown. Enlarged or �dilated� heart is one of the most common types of
cardiomyopathy. The most common symptom patients get with cardiomyopathy is
shortness of breath and swelling of the ankles. Rarer symptoms include dizziness
and chest pain.
Myocarditis � an infection of the heart that is generally caused by a virus. A
person may have a viral illness first and later have symptoms of congestive heart
failure.
Heart valve disease � for example, a faulty mitral valve allows blood to flow
backwards, which means the affected heart chamber has to contract with more force
than usual.
Cardiac ischaemia � reduced blood flow to the heart. This condition can cause heart
pain (angina).
Previous heart attack � a weakened heart muscle may enlarge in order to keep up
with the demands of pumping blood around the body.
Thyroid disease � the thyroid gland regulates many metabolic functions. Untreated,
a thyroid condition can lead to high blood pressure, high blood cholesterol levels,
irregular heartbeat and enlargement of the heart.
Obesity � carrying too much body fat is a risk factor for high blood pressure,
which in turn can cause the heart to enlarge.
Lack of exercise � leading a sedentary lifestyle is a known risk factor for a range
of conditions, including coronary heart disease and high blood pressure.
Old age � as we get older, our arteries lose some of their elasticity. This
�stiffening� of the blood vessels causes high blood pressure, which is a risk
factor for enlarged heart.
Diagnosis of enlarged heart

An enlarged heart is diagnosed using a number of tests including:

Medical history � including a physical examination.
Chest x-ray � this allows the doctor to see the overall shape and size of the heart
and lungs.
Echocardiogram � sound waves sent to a special machine present a picture of the
beating heart, so the doctor can see the heart as its chambers contract and relax.
Doppler study � shows blood flow through the heart valves and evaluates whether the
valves are functioning normally
Electrocardiogram � measures electrical activity in the heart and can assess heart
rhythm and evidence of old infarction or ischaemia.
Treatment of enlarged heart

Treatment depends on the underlying cause but options can include:

Medications to stop the heart from enlarging any further
Addressing the underlying problem (for example through diet, stopping smoking,
exercise and medication to help control high blood pressure, or surgery to replace
a faulty heart valve)
Regular cardiovascular exercise
Adopting a low-fat diet
Dietary adjustments to reduce blood cholesterol levels
Frequent medical check-ups to make sure the treatments are working.
Where to get help
Your doctor
Cardiologist
Things to remember
An enlarged heart isn�t a condition in itself, but a symptom of an underlying
problem that is causing the heart to work harder than normal.
Some of the many causes include coronary heart disease, idiopathic dilated
cardiomyopathy, high blood pressure and heart valve disease.
Treatment depends on the cause, but can include diet and lifestyle adjustments,
medication and surgery.
You might also be interested in:
Blood pressure (high) - hypertension.
Congestive heart failure (CHF).
ECG test.
Heart.
Heart disease - risk factors.
Rheumatic heart disease.
Want to know more?
Go to More information for support groups, related links and references.

Indian Journal of Traditional Knowledge

Vol. 5(3), July 2006, pp. 420-427
Natural remedies for heart diseases
Lokhande PD*, Jagdale SC & Chabukswar AR
Center for Advanced Studies, Department of Organic Chemistry, University of Pune,
Pune 411007, Maharashtra
E-mail: pdlokhande@rediffmail.com
Received 17 March 2005; revised 11 April 200

Heart diseases have posed a great challenge in the developing countries. Heredity,
high blood pressure, diabetes, high serum cholesterol, smoking, improper diet and
stressful life styles are the factors, which are responsible for heart diseases. In
Ayurveda believes that heart diseases are due to the imbalance of three doshas and
bringing the normal levels of these tridoshas back to normal will be major step in
management of heart diseases. Ayurveda treats heart diseases at two levels; first
level is the preventive one and second level deals with the treatment of heart
diseases with different plants and their formulations. In the paper, some of the
plants and formulations, useful in the treatment of heart diseases have been
summarized.
Keywords: Ayurvedic drugs, Heart diseases, Medicinal plants, Natural remedies
IPC Int. Cl.8: A61K36/00,A61P9/00, A61P9/04, A61P9/06, A61P9/08, A61P9/10, A61P9/12
Ayurveda is a traditional and most commonly practiced form of medicine in India1.
Ayurveda comes from the words Ayur (life) and Veda (knowledge). The concept of
Ayurveda is based on a combined study of body (Sharira), sense organs (Indriyas),
mind (Manas) and soul (Atman)2. Equilibrium of all these is related to health. When
an imbalance exists among any one of the three Doshas, Ayurveda suggests a unique
combination of food, exercise, meditation and herbs. Ayurvedic herbs stimulate the
function of specific organs in the body, possibly by altering hormones, affecting
immunity and neurotransmitters, and conveying antioxidant properties 3.
Cardiovascular problems have been dealt in detail in Ayurveda, which describes
Hridaya (heart) as a body organ governing emotions and circulating blood to keep a
person alive and healthy. Heart Disease (Hrudroga) is a global phenomenon. It is
now becoming a major health problem even in developing countries4. The predisposing
factors are heredity, high blood pressure, diabetes, high serum cholesterol and
smoking5. Improper diet and stressful life styles lead to thickening of arteries
(Dhamani praticaya) or hardening of arteries (Dhamani kathinaya) resulting in
angio-obstruction (Vata dosa) and angina (Ruja).
Ayurveda has given different plants and formulations, which are useful in managing
heart diseases6 Table 1).
Angina
It is characterized by pain normally felt in the chest, also occurs in jaws or
abdomen. In some cases, it may cause no symptoms (a condition called silent
ischemia.) If a blood clot suddenly cuts off most or all blood supply to the heart,
a heart attack results7-9. An Ayurvedic mixture of Abana formulation significantly
reduces the frequency and severity of angina attacks. Guggul reduces the serum
cholesterol levels. Green tea helps to avoid clogging arteries. Garlic prevents
oxidation of LDL cholesterol and liver from producing excess fat and cholesterol.
Hawthorn dilates coronary blood vessels, improves blood flow; strengthens heart
muscles and helps to rid of excess salt and water. Turmeric lowers blood
cholesterol levels and checks blood clots. Ginkgo biloba Linn. improves blood flow.
Alfalfa leaves and sprouts help to reduce blood cholesterol levels and plaque
deposits on artery walls. Ginger reduces cholesterol and prevents blood clots.
Citrin (Garcinia cambogia Desr. extract), inhibits synthesis of fatty acids in the
liver. Other beneficial herbs for cardiovascular disorders include barberry, black
cohosh, butcher's broom, cayenne (capsicum), dandelion, ginseng, and valerian root.

Hypertension (High blood pressure)

Blood pressure is the force of blood against the walls of arteries10. Low blood
pressure is related to weakness of the digestive fire. It is common in vata types,
due to poor circulation; in kapha type, it occurs
Table 1�Plants used in Ayurvedic Pharmacopoeia56-58

Plant name
Plant parts used, preparation and dosage
Design and model
Result

Azadirachta indica
Decoction of Azadirachta indica, Boerhaavia diffusa, Cedrusdeodar, Picrorhiza
kurrooa, Terminalia chebula, Tinospora cordifolia, Trichosanthes lobata, Inula
raceomosa (2 gm each, 8 hrly); Commiphora mukul (1/2 gm 8 hrly); and Urgenia indica
100 mg (8 hrly).
14 cases of congestive heart failure
All patients were given the decoction and Urgenia indica; patients with ischaemic
heart disease, cardiomyopathy and cor pulmonale were given powder of Inula
racemosa, while patients with rheumatic heart disease were given Commiphora mukul.
After 2 weeks, 10 patients were cured completely, 2 had bradycardia and 2 were
refractory.
Cassia fistula
Cassia fistula
Albino rats
Administration of Cassia fistula produced a significant decrease in blood and liver
total lipids. Brain, spleen, kidneys and heart followed a similar trend but with
moderate effect. Blood, liver kidneys, spleen and heart total cholesterol
significantly decreased. The level of triglycerides was markedly improved.
Cedrus deodara
Decoction of Azadirachta indica, Boerhaavia diffusa, Cedrus deodara, Picrorhiza
kurrooa, Terminalia chebula, Tinospora cordifolia, Trichosantes lobata, Inula
Racemosa (2 gm each, 8 hrly); Commiphora mukul (� gm 8 hrly), Urgenic indica (100
mg, 8 hrly).
14 cases of congestive heart failure
All patients were given the decoction and Urgenia indica. Patients with ischemic
heart disease, cardiomyopathy and cor pulmonale were given powder of Inula acemosa,
while patients with rheumatic heart disease were given Commiphora mukul. After 2
weeks 10 patients were cured completely, 2 had bradycardia and 2 were refractory.
Cocos nucifera
Coconut and coconut oil
Clinical trial: 32 coronary heart disease16 matched healthy controls
Consumption of coconut oil was found to be similar in both groups. The groups did
not differ in the fat, cholesterol consumption. The result implies no specific role
for coconut or coconut oil in the causation of coronary heart disease in this set
of patients.
Elephantopusscaber
Aqueous and hydroalcoholic extracts (0.3�6 gm/kg) of Elephantopus scaber whole
plant.
Mice, rats
Both extracts induced writhing, loss of muscle tone, ataxia, prostration and death.
Both reduced brewer�s yeast- induced hyperthemia but when given orally did not
affect it. Aqueous extract reduced intestinal transit time while the hydroalcoholic
extract increased it. Given IV, blood pressure and heart rate were reduced.
Myristica fragrans

Ethanolic extract of Myristica fragrans 500 mg/kg orally for 60 days.

Albino rabbits and controls

Total cholesterol, LDL, triglycerides, and cholesterol were significantly reduced.

Extract also showed platelet antiaggregatory ability and a

(Contd)
�Contd

significant decrease of total cholesterol levels in heart and liver.

Picrorhiza kurrooa
Decoction of Azadirachta indica, Boerhaavia diffusa, Cedrus deodara, Picrorhiza
kurrooa, Terminalia chebula, Tinospora cordifolia, Trichosantes lobataand Inula
racemosa (2 gm each, 8 hrly); Commiphora muku, (1/2 gm 8 hrly); Urgenic indica (100
mg, 8 hrly).
14 cases of congestive heart failure
Patients were given Urgenia indica decoction. Patients with ischemic heart disease,
cardiomyopathy and cor pulmonale were given powder of Inula racemosa, while
patients with rheumatic heart disease were given Commiphora mukul. After 2 weeks 10
patients were cured completely, 2 had bradycardia and 2 were refractory.
Terminalia arjuna
Terminalia arjuna bark (500 mg, 8 hourly).
Clinical randomized controlled double-blind trial: 12 with congestive heart failure
NYHA Class IV
Terminalia arjuna compared to placebo therapy was associated with improvement in
symptoms and significant signs of heart failure. On long-term evaluation (phase
II), patient continued to show improvement in symptoms, signs, effort tolerance,
and NYHA class.
Terminalia chebula
Decoction of Azadirachta indica, Boerhaavia diffusa, Picrorhiza kurrooa, Terminalia
chebula, Tinospora cordifolia, Trichosantes lobata, Commiphora mukul (1/2 gm each,
8hrly; Urgenia indica(100 mg, 8 hrly).
14 cases of congestive, heart failure
Patients were given the decoction and Urgenia indica. Patients with ischemic heart
disease, cardiomyopathy and cor pulmonale were given Inula racemosa powder, while
patients withrheumatic heart disease were given Commiphora mukul. After two weeks
10 patients were cured completely, 2 had bradycardia, and 2 were refractory.

because of congestion and stagnation with phlegm clogging and reducing the blood
flow; while in pitta type, it is mainly associated with anemia or damaged liver
function. From Ayurvedic perspective, hypertension is commonly a pitta condition11.
However, it can occur in the other doshas as well. Generally, it is of three types.
Vata hypertension is due to worry, strain, overwork, anxiety or insomnia,
frequently associated with nervous system disorders. Kapha Hypertension is due to
obesity, tiredness, edema, and high cholesterol. Pitta Hypertension is associated
with liver disorders and the accumulation of internal heat.
Treatment includes avoidance of dairy, butter, eggs and high fat foods,
incorporating plenty of hot spices in the diet, particularly mustard and onions12.
Crushed garlic clove with honey is taken once or twice a week. Nutmeg or Saraswat
powder is given with warm milk. Mixture (1-3 gm) of Ashwagandha 1 part, Valerian 1
part, Gotu kola 1 part taken with warm water or with ghee calms the nerves and
relieves heat and stress13. Arjuna preparations like Trikatu are very useful. Herbs
such as gotu kola, calamus, valerian, skullcap, jatamamsi, turmeric, cinnamon,
ginger, cayenne, garlic, black pepper, myrrh, motherwort, hawthorn berries,
barberry, katuka and cardamom are recommended for this condition14. For vata types
garlic is used; for kapha types cayenne or Trikatu is used; while for Pitta types,
saffron or turmeric in a base of aloe gel is used. Gotu kola is another useful herb
for Pitta hypertension. Brahma Rasayana and Saraswat powder are also used.

Heart Attack (Myocardial Infarction)

A heart attack (myocardial infarction) occurs when a coronary artery abruptly fails
to deliver blood to a part of heart. Arteriosclerosis means thickening and
hardening of artery walls due to calcium deposits15. In atherosclerosis, the
deposits consist of fatty substances, and artery walls lose elasticity and harden.
Both arteriosclerosis and atherosclerosis affect circulation. If not taken care of
they can ultimately lead to high blood pressure and to angina (chest pain), heart
attack, stroke, and/or sudden cardiac death.
Kapha and pitta types are due to fat accumulations. Vata type is from the hardening
of the arteries16,17. Treatment for arteriosclerosis is similar to the treatment of
heart diseases and for hypertension. Hypertension usually follows arteriosclerosis.
Guggul lowers high cholesterol and is useful for Kapha. It improves circulation,
reduces pain, removes accumulations and promotes healing. 1 gm is taken in the
morning and evening for three months. Garlic is taken along with honey. Calamus,
turmeric, elecampane, aloe vera gel with turmeric or safflower, katuka, myrrh,
saffron, motherwort, and hawthorn berries are other useful herbs.

Cardiomyopathies (Vatika Hrudoga)

Vatika Hrudyoga comprises of an umbrella of disorders. The main features include
excruciating pain in heart, pricing, squeezing and crushing. Other features include
breathlessness, feeling of emptiness in chest, palpitation, sudden lethargy, and
loss of consciousness18. The Ayurvedic treatment of IHD comprises of Panchkarmas,
which mainly includes Virechna (Purgation) and Basti (medicated enemas). Internal
medicines include drugs like Ajmoda, Vishatinduka and Bold. Externally a local
treatment, known as Hrid-Basti, which is a type of oleation (Snehana) incorporating
application of oils, decoctions, juices of herbs locally on mid sternal zone,
forming a wall of wet gram paste is given.

Congenital heart disease & cardiovascular diseases

Congenital means inborn or existing at birth. In order to rectify the defects
cardiac surgery is needed 19. According to Caraka Samhita of Agnivesa, plants
termed as cardiac tonic are as follows

Botanical name/Family
Common names
Useful parts

Magnifera indica Linn. (Anacardiaceae)

Aam, Amba
Fruit
Gmelina asiatica, Linn. (Verbenaceae)
Badhar
Fruit
Carissa carandas, Linn. (Apocynaceae)
Karanda
Fruit, Bark, Leaves
Garcina indica Choisy (Guttifereae)
Amsul
Fruit
Garcinia pedunculata Roxb. (Guttifereae)
Amlavettas
Fruit
Ziziphus jujuba Mill. ; Ziziphus nummularia Wight & Arn. (Rhamnaceae)
Kuval, Bor
Fruit, Leaves
Punica Granatum Linn. (Lythraceae)
Anardana
Flowers, Fruits
Citrus medica Linn. (Rutaceae)
Mahalung
Fruit

Emblica officinalis Gaertn. (Amla/Amalaki) is used to rebuild and maintain new

tissues and increases red blood cell count. It is the highest natural source of
vitamin C and reduces pitta without aggravating vata or kapha. It is a one of three
herbs used in triphala, the primary Ayurvedic tonic for maintaining health 20. In
Ayurveda, Amla fruits are reputed Rasayanas and rejuvenators. They are extensively
used in Ayurvedic preparations for the treatment of a number of diseases and
debility states and are one of the three constituents of triphala, which is a
remedy for constipation, indigestion and hyperacidity21. It contains gallic and
ellagic acids, hydrolysable tannins, ascorbic acid (Vitamin C), phyllembic acid
emblicol, and alkaloids22. This Plant has shown its mettle in the areas of
digestive, heart health, and diabetics23-25. Plant even help to reduce the toxic
side effects of chemotherapy, restores antioxidant status to the kidneys, and
reduces blood sugar levels in diabetics26-27. They have potent immunomodulatory,
immunostimulant, antipyretic, spasmolytic, antifungal, antibacterial and antiviral
activities.
Terminalia arjuna (Roxb.) Wight & Arn. (Arjuna) bark is used as medicine28. Six
teaspoonfuls of Arjunarishta are given to the patient twice daily after food with
an equal quantity of water29. Arjuna is a cardiac tonic used in Ayurveda for a
variety of heart conditions30. Often it is combined with ashwagandha, brahmi and
guggul in heart formulas. Arjuna is a coronary vasodilator, protects the heart,
strengthens circulation, and helps to maintain the tone and health of the heart
muscle. 1/2 teaspoon (500 milligrams to one gram) 3 times a day is given with honey
and warm water. Administered at a dose of 15 mg/kg, arjunolic acid could protect
against damage wreaked by myocardial necrosis, which translates into irreparable
damage to heart cells31.
Ocimum sanctum Linn (Tulsi) is used against a wide variety of diseases32. Tulsi
leaves are household remedy for common cold and cough. Ayurvedic text describes the
herb to be aromatic and a pacifier/normaliser of vitiated and deranged Kapha-vata
doshas and is useful in blood disorders (Raktavikar). Phytochemical investigations
of leaves have shown the presence of flavones, glycosides, gallic acid and its
ester, caffeic acid and volatile oil having eugenol (70.5%) as the main component.
Tulsi leaf extract has shown adaptogenic, antiinflammatory and antiasthmatic
activities.
Picrorhiza kurroa Royal ex. Benth. (Kutaki) rhizome is used for the treatment of
fever, jaundice, liver afflictions, bile disorders, against infections,
inflammatory and drainage morbid conditions33. The herb pacifies the vitiated
Kapha-vata doshas and corrects imbalance in them. It is astringent, bitter and a
valuable tonic, extensively employed for rejuvenation therapy. It contains phenolic
glycosides (androsin-aglycone, apocymine), Iridoid glycosides (Kutkoside,
picrosides I, II, III), Cucurbitaceous glycosides, vinallic acid, cinnamic acid.
Active constituents of the herb have been found to be responsible for the
inhibition of free oxygen radicals. Picroliv, a standardised fraction from root
shows hepatoprotective activity against liver cirrhosis and liver toxicity,
promoting the repair of injured tissues. The standard fraction, Picroliv also has
exhibited hypolipidaemic action, altering lipolytic activities in plasma, liver,
heart and adipose stimulating catabolism of risky low-density lipoprotein (LDL)
while increasing the beneficial high-density lipoprotein (HDL) fraction. Roots also
show antiasthmatic activity.
Tinospora cordifolia (Willd) Miers (Giloe/Guduchi) consisting of stem of the herb,
restores a balance among the vitiated and deranged kapha, vata and pitta doshas and
is alterative and bitter. Categorised in Ayurveda as Rasayana, the herb is used in
inflammation and rheumatism, diabetes, jaundice and allied liver problems and
malarial fever 34. Chemical investigations of the stems have isolated compounds,
broadly classified as alkaloids (berberine), glycosides (furanoid diterpene
glycoside), lactones (Tinosporon, tinosporide), stearols and fatty acids. They are
found to be rich in calcium (1.06%). Trace elements-manganese, zinc, copper and
cobalt are also reported. T. cordifolia herb possesses potent immunomodulatory and
immunostimulant activities. It produces significant leucocytosis (increased number
of leucocytes in blood) in response to infection and predominant neutrophilia
affording an increased protection against susceptibility to pathogenic infections.
The herb is an adaptogen, and induces a marked protection against restraint stress-
induced ulceration and other stress-mediated effects. Utility and therapeutic value
of the herb has been demonstrated in various liver disorders including jaundice,
and exhibited antihyperglycaemic activity35. Toxicity study has shown the herb to
be non-toxic with wide safety margin36.
Convolvulus pluricaulis Choisy (Shankhpushpi) being astringent and bitter improves
Kapha-vata-pitta doshas. Plant has shown presence of glycosides, coumarins,
flavonoids and alkaloids. Alkaloid Shankhapushpine, has been identified as active
principle. The herb induces a feeling of calm and peace, good sleep and a relief in
anxiety, stresses, and mental fatigue, producing a significant reduction in the
level of anxiety, neuroticism arising due to various levels of stresses. The herb
appears to produce its action by modulation of neuro-chemistry of the brain.
Further, the herb is non-toxic and its use does not produce any side effects.
Allium sativum Linn. (Garlic) is most important substance helpful in alleviating
vata doshas controlling blood pressure and lowering cholesterol. Garlic is known to
lower blood pressure, boost immune system, fight infections, and prevent cancer 37.
Garlic lowers the over all cholesterol counts and helps to combat cold and flu38.
It also is helpful against parasites, bacterial infection, cancer, ulcers and even
slows the growth of existing tumors.
Cinnamomum zeylanicum Breyn. (Cinnamon) powder with honey reduces the level of
cholesterol in the blood by 10% within 2 hrs39.
Crat�gus oxycantha Linn. (Hawthorn berry) tincture strengthens heartbeat and
improves circulation in the blood vessels of the heart. Hawthorn extract gently
dilates the coronary vessels increasing the supply of arterial blood to the heart.
This action enhances oxygen utilization, resulting in a stronger, and more powerful
heart muscle. Crataegus differs from digitalis, which is also an effective heart
stimulant, in that it does not produce side effects. Crataegus strengthens the
overall effect of digitalis40.
Centella asiatica Urban (Mandukaparni) has shown promise in cognitive, circulatory,
digestive health and venous hypertensive microangiopathy41-42. In microangiopathy
in diabetics, the triterpenic fraction (60 mg twice daily for 12 months) decreased
capillary filtration and edema, which in turn improved the condition43.
Mucuna prurita Hook. (Kapikachchha) exhibited efficacy in heart disease and
diabetes. Alcohol extract of M. pruriens inhibited lipid peroxidation, a factor in
free radical damage and heart disease44. The extract had an antilipid peroxidation
property, due to its effect in removing hydroxyl radicals and super oxides. 200
mg/kg/d exerted maximum anti-hyperglycemic effects after six weeks45.
Withania somnifera Dunal (Ashwagandha) has immunostimulatory properties, exerts a
positive influence on the endocrine, cardiopulmonary and central nervous systems
and improves memory46.
Azadirachta indica A. Juss. (Neem) is helpful in coronary artery disease and heart
arrhythmias47, in addition to protecting against ulcers and strep infections48.
Gymnema sylvestre R. Br. (Meshasringa) shows hypoglycemic and anti-hyperglycemic
activity, useful for diabetics49. An extract of leaves given to rats for three
weeks influenced lipid metabolism, improving serum cholesterol and triglyceride
levels50.

Ayurvedic formulations
The principles underlying Ayurvedic formulations can be broken into four parts:
synergy, opposition, protection and enhancement. The various formulations used in
heart diseases are as follows51-55:
Chandraprabha, is used to maintain healthy cholosterol levels and blood sugar
levels. Abana containing arjuna, ashwaganda, and shatavari promotes healthy
cholesterol levels, helps regulate blood pressure and supplies needed oxygen to the
heart. Abana regulates serum lipids by lowering the cholesterol, triglyceride, low-
density lipoprotein (LDL) and very low-density lipoprotein (VLDL) levels, and
restores the cardioprotective high-density lipoprotein (HDL) level. Abana also
reduces platelet aggregation. Abana reduces the sensitivity of the heart to
adrenergic stimulation and improves the contractility of the heart by exerting a
positive ionotropic action. Digest Ease is a digestion formula for pitta. It
supports proper digestion and absorption for individuals prone to hyperacidity and
heartburn. Arjuna, bala and hawthorn berry are effective in nourishing and
strengthening heart muscle, stimulating circulation and oxygen flow. It promotes
healthy cholesterol levels aiding in the defense of heart disease. Arjuna (Koha)
paste is helpful in heart diseases, acne, and diarrhoea. Cholest Control, an
Ayurvedic herbal formulation helps to reduce cholesterol levels in the body. Guggul
is effective in arthritis, bronchitis, atherosclerosis, diet & weight loss, PMS,
stress, and ulcers. Avipattikar churna containing Vindanga, Sharkara, Lavanga,
Pipli, Trifala, Mustaka, Ela, Tejpata, and Kala mirch is effective in acidity,
heartburn, gastritis, anorexia, loss of appetite, constipation, and hyperactivity.
Bala (Sida cordifolia Linn.) is commonly used for heart diseases, soothing for
arthritic pain, rejuvenative, nutritive, and stimulant for the heart, helps in the
inflammation of nerve tissue. Bala pacifies high vata-pitta conditions. Haritaki
(Terminalia chebula Retz.; C.B. Clarke is used in cough, asthma, abdominal
distention, tumors, heart disease, skin disease, and itching. Tribulus terrestris
Linn. is also used in cardiovascular diseases. Cardoclear regularizes heart
function, maintains lipid and cures heart diseases. Hriday Amrit is a remedy for
coronary heart diseases & other cardiac disorders. Hriday Amrit is composed of
Terminalia arjuna, Boerhaavia diffusa Linn., Plumbago zeylanica Linn., Terminalia
chebula Retz., Withania somnifera Dunal, Vitex negundo Linn., Vanda roxburghii R.
Br., Solanum nigrum Linn., Tinospora cordifolia Miers ex Hook f.& Thoms., Piper
longum Linn., Cyperus scariosus R. Br., and Embelia ribes Burm. f.
Baidyanath Arjunarishta is a cardiac tonic. Art Capsules contains garlic, hawthorn,
passionflower extract and vitamin E. Muktavati containing Bacopa monnieri (Linn.)
Pennel., Evolvulus alsinoides Linn., Inula racemosa Hook. f., Celastrus paniculatus
Willd., Withania somnifera Dunal, Onosma bracteatum Wall., Tinospora cordifolia
Miers ex Hook f.& Thoms., red coral powder and pearls is a remedy for high blood
pressure, anxiety and Insomnia. Hinguvachaadi Gutika is useful in pain in the
heart, difficulty in passing urine, anemia, haemorrhoids, hiccups, respiratory
disorders, and cough. Arjuna Nectar improves poor blood circulation, increases red
blood cell count, Coronary heart disease, Heart palpitations, Irregular heartbeat,
arteriosclerosis and angina pectoris. Parthadyarishtam containing Arjuna for heart
and lung diseases, as a cardiac stimulant and for controlling blood pressure.
Hridayarnava rasa and Prabhakara vati are given in various cardiovascular diseases.
Mrigamadasava is the ideal drug at the time of acute attacks. The Blisfil Joy
herbal supplement is a restorative containing Arjuna, Ashwagandha and other
nourishing herbs.

Conclusion
Ayurveda has offered a novel remedies for the management of heart diseases. Plants
such as Arjuna, Garlic, Cinnamon and their formulations are very useful in treating
heart diseases. Guggula and pushkarmula has been shown to be a best combination for
treatment of Ischemic heart diseases. Chandraprabha and Abana formulations are
helpful in lowering the cholesterol levels. Research is required to find out the
specific molecules, responsible for the their beneficial actions in heart diseases
along with their toxicological studies. The detail investigation of the plants and
their constituents for their pharmacological actions will help in the development
of new molecules for the treatment of heart diseases.
References
1. Agnivesa, Caraka Samhita: English Translation and
Critical Exposition Based on (Cakrapani Datta�s Ayurveda Dipika)/Ram Karan Sharma
and Vaidya Bhagwan Dash, 7 Vol (Chowkhamba Sanskrit Studies), 2002, 3304.
2. Sharma Priya Vrat, Susruta-Samhita: English
Translation and Dalhana�s Commentary along with critical notes, (Chaukhambha
Visvabharati, Varanasi), 3 Vol, 2001, 1983.
3. Miller AL, Botanical influences on cardiovascular
disease, Alt Med Rev, 3(6) (1998) 422.
4. Kannel WB, Hazards, risks, and threats of heart
disease from the early stages to symptomatic coronary heart disease and cardiac
failure, Cardiovasc Drugs Ther, 11 Suppl (1997) 199.
5. Lee CD, Blair SN, Jackson AS, Cardio respiratory
fitness, body composition, and all-cause and cardiovascular disease mortality in
men, Am J Clin Nutr, 69 (1999) 373.
6. Srikantha Murthy KR, Bhavaprakasa of Bhavamisra,
2 Vol (Krishnadas Academy, Varanasi), 2001, 1622.
7. Sharma VN, Essentials of Pharmacology, 1st
edition, (CBS publishers and Distributors, New Delhi) 1999, 150.
8. Sasikumar CS, Devi CS, Effect of Abana an
Ayurvedic formulation on lipid peroxidation in experimental myocardial infarction
in rats, Exp Biol, 38(8) (2000) 827.
9. Antani JA, Kukri RD & Antani NJ, Effect of Abana
on ventricular function in ischemic heart disease, Jpn Heart J, 31(6) (1990) 829.
10. Andres Goth, Medical Pharmacology Principles and
Concepts, 11th edn (CV Mosby Company, Taranto), 1984, 419.
11. Deshpande AP, Jawalgekar RR & Ranade S, Dravyagun
Vidnyan, Part I & II, (Anmol Prakashan, Pune), 1999, 5, 335.
12. Astanga-Hrdaya of Vagbhata: The Book of Eight
Branches of Ayurveda/translated by A Board of Scholars, 3 Vol, 1999, 1263.
13. Astanga Samgraha of Vagbhata: Sutra Sthana/S.
Suresh Babu, Vol 4 (Chaukhambha Orientalia, Varanasi), 2004, 356
14. Patwardhan Bhushan & Hooper M, Ayurveda and future
drug development, Int J Alt Comp Med, 10 (12) (1992) 9-11.
15. Barar FSK, Essentials of Pharmacotherapeutics, Vol
3 (S Chand & Company Ltd, New Delhi), 2000, 234.
16. Sharma Priya Vrat, Bhela-Samhita: Text with English
Translation, Commentary and Critical Notes/KH Krishnamurthy, Reprint. Varanasi,
Chaukhambha Visvabharati, Vol 24, 2003, 600, (Haridas Ayurveda Series, 8)
17. Sastry JLN, Dravyaguna Vijnana: Fundamental
Principles of Pharmacotherapeutics in Ayurveda, Vol I, Vol 21 (Chaukhambha
Orientalia, Varanasi), 2002, 440.
18. Tripathi KD, Essentials of Medical Pharmacology,
5th edn, Vol 4 (Jaypee Brothers, New Delhi), 2003, 483.
19. Satoskar RS, Bhandarkar SD & Ainapure SS,
Pharmacology and Pharmacotherapeutics, Vol 18 (Popular Prakashan, Mumbai), 2003,
362.
20. Ayurveda: The Science of Living (Health and Vigour
Forever)/VB Athavale. Delhi, Vol 10 (Chaukhamba Sanskrit Pratishthan,Varanasi),
2003, 164
21. Sairam K, Rao Ch V, Babu MD, Kumar KV, Agarwal VK &
Goel RK, Anti-ulcerogenic effect of methanolic extract of Emblica officinalis: an
experimental study, J Ethnopharmacol, 82 (1) (2002) 1.
22. Anila L & Vijayalakshmi NR, Flavonoids from Emblica
officinalis and Mangifera indica--effectiveness for dyslipidemia , J
Ethnopharmacol, 79 (1) (2002) 81.
23. Bhattacharya SK, Bhattacharya A, Sairam K & Ghosal
S, Effect of bioactive tannoid principles of Emblica officinalis on ischemia-
reperfusion-induced oxidative stress in rat heart, Phytomed, 9 (2) (2002) 171.
24. Khan MT, Lampronti I, Martello D, Binohi N, Jabbar
S, Choudhari MS & Dutta BK, Identification of pyrogallol as an antiproliferative
compound present in extracts from the medicinal plant Emblica officinalis: effects
on in vitro cell growth of human tumor cell lines, Int J Oncol, 21 (1) (2002) 187.
25. Manjunatha S, Jayral AK, Bijlani RL, Sachdeva V &
Gupta SK, Effect of Chyawanprash and vitamin C on glucose tolerance and lipoprotein
profile, Indian J Physiol Pharmacol, 45 (1) (2001) 71.
26. Haque R, Bin-hafeza B, Ahmed I, Parvez S, Pandey S
& Raisuddin S, Protective effects of Emblica officinalis Gaertn, in
cyclosphosphamide-treated mice, Hum Exp Toxicol, 20 (12) (2001) 643.
27. Sabu MC & Kuttan R, Anti-diabetic activity of
medicinal plants and its relationship with their antioxidant property, J
Ethnopharmacol, 81 (2) (2002) 155.
28. Ayurvedic Encyclopaedia: Theories of Ayurveda/A.
Lakshmipathi. Delhi, 2 Vol (Chaukhamba Sanskrit Pratishthan, Varanasi), 2004, 1197
29. Bharani A, Ganguli A, Mathur LK, Jamra Y & Raman
PG, Efficacy of Terminalia arjuna in chronic stable angina: a double-blind,
placebo-controlled, crossover study comparing Terminalia arjuna with isosorbide
mononitrate, Indian Heart J, 54 (2) (2002) 170.
30. Materia Medica and Herbal Pharmacology/Amritpal
Singh, Vol 5 (Chaukhambha Orientalia, Delhi), 2005, 222
31. Sumitra M, Manikandan P, Kumar DA, Artuselvan N,
Balkrishnan K, Manmohan BM & Pavankrishnan R, Experimental myocardial necrosis in
rats: role of arjunolic acid on platelet aggregation, coagulation and antioxidant
status, Mol Cell Biochem, 224 (1-2) (2001) 135.
32. Treas and Evans Pharmacognosy (Saunders Publisher),
14th editon, 1997, 314.
33. Scartezzini P & Speroni E, Review on some plants of
Indian traditional medicine with antioxidant activity, J Ethnopharmacol. , 71(1-2)
(2000) 23.
34. Chopra A & Doiphode VV, Ayurvedic medicine. Core
concept, therapeutic principles, and current relevance, Med Clin North Am, 86(1)
(2002) 75.
35. Dravyaguna Vijnana: Fundamental Principles of
Pharmacotherapeutics in Ayurveda, Vol I by JLN Sastry, Chaukhambha Orientalia,
Varanasi, 2002, 440.
36. Pandit S, Biswas TK & Debnath PK, Chemical and
pharmacological evaluation of different Ayurvedic preparations of iron, J
Ethnopharmacol, 65(2) (1999) 149.
37. Singh RH, An assessment of the Ayurvedic concept of
cancer and a new paradigm of anticancer treatment in Ayurveda, J Alt Comp Med, 8(5)
(2002) 609.
38. Traditional Knowledge on the Medicinal Plants of
Ayurveda/Sandhya Singh, Preeti Pandey and Sushil Kumar, Vol 6 (Central Institute of
Medicinal and Aromatic Plants, Lucknow), 2000, 392.
39. Go VL & Champaneria MC, The new world of medicine:
prospecting for health, Nippon Naika Gakkai Zasshi, 91 Suppl (2002) 159.
40. Ayurvedic Management of Stroke (Hemiplegia)/K
Nishteswar, Vol 6 (Chowkhamba Krishnadas Academy, Varanasi), 2003, 69.
41. Incandela L, Belcaro G, Nicolaides AN, Cesarone MR,
Sanctis MT, Corsi M, Bavera P, Ippolito E & Griffin M, Total triterpenic fraction
of Centella asiatica in the treatment of venous hypertension: a clinical,
prospective, randomized trial using a combined microcirculatory model, Angiology,
52 Suppl (2)(2001) S61.
42. De Sanctis MT, Belcaro G, Incandela L, Cessarone
MR, Griffin M, Ippolito E & Bucci M, Treatment of edema and increased capillary
filtration in venous hypertension with total triterpenic fraction of Centella
asiatica: a clinical, prospective, placebo-controlled, randomized, dose-ranging
trial, Angiology, 52 Suppl (2)(2001) S55.
43. Incandela L, De Sanctis MT, Belcaro G, Cessarone
MR, Griffin M, Lppolito E & Bucci M, Treatment of diabetic microangiopathy and
edema with total triterpenic fraction of Centella asiatica: a prospective, placebo-
controlled randomized study, Angiology, 52, Suppl (2) (2001) S27.
44. Tripathi YB & Upadhyay AK, Effect of the alcohol
extract of the seeds of Mucuna pruriens on free radicals and oxidative stress in
albino rats, Phytother Res, 16 (6) (2002) 534.
45. Rathi SS, Grover JK & Vats V, The effect of
Momordica charantia and Mucuna pruriens in experimental diabetes and their effect
on key metabolic enzymes involved in carbohydrate metabolism, Phytother Res, 16 (3)
(2002) 236.
46. Dhuley JN, Mishra LC, Singh BB & Dagenais S,
Nootropic-like effect of ashwagandha in mice, Phytother Res, 15 (6) (2001) 524.
47. Khosla P, Gupta A & Singh J, A study of
cardiovascular effects of Azadirachta indica on isolate perfused heart
preparations, Indian J Physiol Pharmacol, 46 (2) (2002) 241.
48. Vanka A, Tandon S, Rao SR, Udupa N & Ramkumar P,
The effect of indigenous Neem mouth wash on Streptococcus mutans and lactobacilli
growth, Indian J Dent Res, 12 (4) (2001) 193.
49. Grover JK, Yadav S & Vats V, Medicinal plants of
India with anti-diabetic potential, J Ethnopharmacol, 81(1) (2002) 81.
50. Shigematsu N, Asano R, Shimosaka M & Okazaki M,
Effect of administration with the extract of Gymnema sylvestre R. Br leaves on
lipid metabolism in rats, Biol Pharm Bull, 24 (6) (2001) 713.
51. Chopra A, Lavin P, Patwardhan B & Chitre D,
Randomized double blind trial of an ayurvedic plant derived formulation for
treatment of rheumatoid arthritis, J Rheumatol, 27 (6) (2000) 1365.
52. Paranjpe P & Kulkarni PH, Comparative efficacy of
four Ayurvedic formulations in the treatment of acne vulgaris: a double blind
randomised placebo-controlled clinical evaluation, J Ethnopharmacol, 49(3) (1995)
127.
53. Hu FB, Stampfer MJ & Rimm E, Dietary fat and
coronary heart disease: a comparison of approaches for adjusting for total energy
intake and modeling repeated dietary measurements, Am J Epidemiol, 149 (1999) 531.
54. Kinosian B, Glick H & Garland G, Cholesterol and
coronary heart disease: predicting risks by levels and ratios, Ann Intern Med, 121
(1994) 641.
55. Bordia A, Effect of garlic on blood lipids in
patients with coronary heart disease, Am J Clin Nutr, 34(10) (1981) 2100.
56. el-Saadany SS, el-Massry, labib SM & Sitohy MZ, The
biochemical and role and hypocholesterolaemic potential of the legume Cassia
hypercholesterolaemic rats, Nahrun, 35(8) (1991) 807.
57. Kumar PD, The role of coconut and coconut oil in
coronary heart disease in Kerala, South India, Trop Doct, 27(4) (1997) 215.
58. Abdul-Ghani AS & Amin R, The vascular action of
aqueous extracts of Foeniculum vulgare leaves, J Ethnopharm, 24 (1988) 213.

������
*Corresponding author