Hrid Roga: Causes, Types, Symptoms of Heart Disease As Per Ayurveda

Article by Dr Raghuram Y.S. MD (Ay) & Dr Manasa, B.A.M.S
Hrid Roga means Cardiac Disorders in Ayurveda. Ayurveda explains in detail regarding how Ayurveda is afflicted with vitiated Vata, Pitta and Kapha, and the resultant symptoms. 

Nidana

Hrid Roga Nidana (Causative Factors of Hrid Roga)
अति उष्ण गुरु अन्न कषाय तिक्त श्रम अभिघात अध्यशन प्रसङ्गैः।
संचिन्तनैः वेग विधारणैः च हृदयामयः पञ्च विधः प्रदिष्टः॥(मा.नि.२९/१)
व्यायाम तीक्ष्ण अति विरेक वस्ति चिन्ता भय त्रास मदाभिचाराः।
च्छर्धाम सन्धारण कर्षणानि हृद् ओग कर्तृणि तथा अभिघातः॥(च.चि.२६)

• Ati Ushna – Consumption of too hot foods
• Ati Guru – Consumption in excess of foods which are heavy to digest
• Ati Amla – Excessive consumption of sour foods or taste
• Ati Kashaya – Excessive consumption of astringent foods or taste
• Ati Tikta – Excessive consumption of bitter foods or taste
• Ati Shrama – Excessive physical exhaustion, laborious work
• Abhighata – Injuries (physical and mental trauma)
• Adhyashana – Excessive consumption of foods, frequent eating (even before the previous taken food has been digested)
• Ati Prasanga (Ati Vyavaya) – Excessive indulgence in sexual activities (intercourse)
• Sanchintana – Excessive thinking, stress, over-anxiety
• Vega Vidharana Sandhaarana – Forcibly withholding the natural urges (impending body reflexes)
• Vyayama – Excessive physical exercise
• Teekshna / Ati Virechana – administration of strong purgatives, excessive administration of purgation therapy
• Teekshna / Ati Vasti – administration of strong enemas, excessive administration of enema treatments
• Bhaya – fear
• Trasa – panic
• Gadatichara – improper or inadequate treatment of other diseases
• Chardi – frequent vomiting, excessive vomiting
• Ama dosha – excessive ama or toxins in the body (ama = immature essence of digestion in circulation)
• Karshana – emaciation

The Hridaya or heart gets contaminated on consumption of the above said causes either individually or collectively (on repeated exposure to causes) leading to the manifestation of 5 types of Hrid Roga or Cardiac disorders.

Samprapti

Samprapti (pathogenesis) of Hrid Roga
दूषयित्वा रसं दोषा विगुणा हृदयं गताः।
हृदि बाधां प्रकुर्वन्ति हृद्रोगं तं प्रचक्षते॥(सु.उ.४३)
Due to the consumption (exposure) of Nidanas (causative factors), the doshas get vitiated. These vitiated doshas in turn contaminate the rasa dhatu (nutritional fluid in circulation) and enter the Hridaya (heart). On entering the heart through rasa dhatu, the doshas trouble the heart and cause Hrid Roga.

Samanya Lakshana

Hrid Roga Samanya Lakshanas (Common symptoms of Hrid Roga)
वैवर्ण्य मूर्च्छा ज्वर कास हिक्का श्वास आस्य वैरस्य तृषा प्रमोहाः।
च्छर्दिः कफ उत्क्लेश रुजो अरुचिः च हृद्रोगजाः स्युः विविधाः तथा अन्ये॥(दृढबल, च.चि.२६)

• Vaivarnya – discoloration
• Murcha – fainting, loss of consciousness
• Jwara – fever
• Kaasa – cough
• Hikka – hiccough
• Shwasa – breathlessness, shortness of breath, dyspnea
• Aasya vairasya – feel of abnormal tastes in the mouth
• Trusha / trishna – thirst
• Pramoha – confusion
• Chardi – vomiting
• Kapha utklesha – excessive regurgitation of phlegm into the mouth
• Ruja – chest pain, abdomen pain
• Aruchi – tastelessness, anorexia

Causes of Heart Diseases As Per Ayurveda (Hridroga Nidana)

Types

Types of Hrid Roga
Hrid Roga is of 5 types:

• Vataja Hrid Roga – Heart disease caused by vitiated Vata
• Pittaja Hrid Roga – Heart disease caused by vitiated Pitta
• Kaphaja Hrid Roga – Heart disease caused by vitiated Kapha
• Tridoshaja Hrid Roga – Heart disease caused by all the 3 vitiated doshas (Vata, Pitta and Kapha)
• Krimija Hrid Roga – Heart disease caused by worms, bacteria (infection), microorganisms

Vataja Hridroga

Vataja HrudRoga
आयम्यते मारुतजे हृद्रोगं तुध्यते तथा।
निर्मथ्यते दीर्यते च स्फोट्यते पाठ्यते अपि च॥(सु.उ.४३)

• Aayamyate – expansion of the heart
• Tudyate – Pricking. throbbing pain in the heart
• Nirmathyate – churning pain in the heart
• Deeryate – tearing pain in the heart
• Sphotyate – blasting pain in the heart
• Paatyate – cutting pain in the heart

Pittaja Hridroga

Pittaja Hrudroga
तृष्णा ऊष्मा दाह चोषाः स्युः पैत्तिके हृदय क्लमः।
धूमायनं च मूर्च्छा च स्वेदः शोषो मुखस्य च॥(सु.उ.४३)

• Trishna – Severe thirst
• Ushnataa – Excessive temperature, heat in the body
• Daaha – Burning sensation
• Chosha – sucking pain
• Klama – excessive tiredness, fatigue
• Dhoomaayanam – feel as if smoke is being eliminated from the mouth (body)
• Moorchaa – fainting, loss of consciousness
• Sweda – excessive sweating
• Mukha shosha – dryness of the oral cavity (mouth)

Kaphaja Hridroga

Kaphaja Hrid Roga
गौरवं कफ संस्रावो अरुचिः स्तम्भो अग्नि मार्दवम्।
माधुर्यं अपि च आस्यस्य बलासावतते हृदि॥(सु.उ.४३)

• Gouravam – heaviness in the body (in the region of the heart, chest)
• Kapha samsraava – excessive salivation / froth from the mouth
• Aruchi – tastelessness, anorexia
• Stambha – stiffness, rigidity (in the body, heart and chest)
• Agni maardavam – loss of appetite, sluggish digestion (low metabolism)
• Mukha maadhurya – feel of sweet taste in the mouth

Tridoshaja Hridroga

Tridoshaja Hrid Roga
विध्यात् त्रिदोषं तु अपि सर्व लिङ्गम्।(च.चि.२६)
In Tridoshaja Hrid Roga, all the symptoms mentioned in Vataja, Pittaja and Kaphaja Hrid Rogas will be collectively present.

Krimija Hridroga

Krimija Hrid Roga
त्रिदोषजे तु हृद्रोगे यो दुरात्मा निषेवते।
तिल क्षीर गुडादीनि ग्रन्थिः तस्य उपजायते।
मर्म एक देशे संक्लेदं रसः च अस्य उपगच्छति।
संक्लेदात् क्रिमयः च अस्य भवन्ति उपहत आत्मनः॥(च.सू.१७)
तीव्र अरित् तोदं क्रिमिजं स कण्डूम्।(च.चि.२६)
उत्क्लेदः ष्ठीवनं तोदः शूलं हृल्लसकः तमः।
अरुचिः स्याव नेत्रत्वं शोथः च क्रिमिजे भवेत्॥(सु.उ.४३)

The person who is undisciplined and doesn’t have self control consumes in excess Tila (sesame and its products, preparations of sesame), Dugdha (milk), Guda (jaggery) etc out of greed while having Hrid Roga, a granthi (cystic swelling, nodule) is formed in a portion of Hridaya Marma (heart which is also one of the delicate and sensitive organ of the body). Gradually the granthi ges filled with kleda (vicious fluid, exudates). To this the rasa in circulation gets added and increases exudates and consequent dampness. This forms an ideal environment for the krimis to manifest (worms, microorganisms, bacteria etc). Krimis get manifest in this kleda in the person who consumes apathya (incompatible and unwholesome foods). Severe pain and discomfort gets manifest in the heart due to the development of these krimis. The person also experiences toda (pricking pain) in the heart region.

Below mentioned are the symptoms of Krimija Hrid Roga –

• Utkleda – Nausea, feel to vomit
• Shteevana – Excessive spitting
• Toda – Pricking pain
• Shula – Colic, Pain in chest
• Hrillasa – Water brash, nausea
• Tama – feel of darkness in front of the eyes
• Aruchi – tastelessness, anorexia
• Shyaava netratvam – Blackish brown discoloration (bluish black) of eyes
• Shosha – depletion of the body, excessive dryness of the body, wasting of the body

Upadrava

HridRoga Upadrava (Complications of heart diseases)
क्लमः सादो भ्रमः शोषो ज्ञेयाः तेषाम् उपद्रवाः।
क्रिमिजे क्रिमिजातीनां श्लैष्मिकाणां च ये मताः॥(मा.नि.२९/७)
हृदये अभिहते कास श्वास बलक्षय कण्ठ शोष क्लोम अपकर्षण जिह्वा निर्गम मुख तालु शोष अपस्मार उन्माद प्रलाप चित्त नाशादयः स्युः।(च.सि.९)

• Kloma Saada / Kloma apakarshana – weakness of kloma (wind pipe, lungs)
• Bhrama – giddiness
• Shosha – wasting of or excessive dryness of the body, tissue depletion
• Krimija Upadrava – complications of Krimi roga are manifested in Krimija Hridroga, likewise the kapha symptoms (symptoms of vitiated kapha) will also be manifested in krimija Hrid Roga
• Kasa – cough
• Shwaasa – dyspnoea, breathlessness, shortness of breath
• Bala kshaya – deterioration of strength
• Kantha Shosha – Dryness of throat
• Jihwa nirgamana – protrusion of tongue from the mouth
• Mukha shosha – dryness of the oral cavity
• Talu Shosha – dryness of palate (roof of the mouth)
• Apasmara – loss of memory, memory related disorders, epilepsy
• Unmada – insanity, mania, psychological disorders
• Pralapa – delirium
• Chitta Nasha – destruction of mind related and thought related activities

Just Before Finishing –
This article covers the causative factors, general symptoms, dosha specific symptoms, types and complications of Hrid Roga (heart disorders) as explained in Ayurvedic texts

Effective decoctions for heart diseases from Sahasrayogam

1. Hridrogahara Kashayam

Ref – Sahasrayogam, Kashaya Prakaranam, 32

a. Dhanyakadi Kashayam

b. Mashadi Kashayam

2. Pushkarahwadi Kashayam

Ref – Sahasrayogam, Parishishta Prakaranam, 38

3. Vidalin Veradi Kashayam

Ref – Sahasrayogam, Parishishta Prakaranam, 67

4. Trayantyadi Kashayam

Ref – Sahasrayogam, Parishishta Prakaranam, 111

Other Yogas From Sahasra Yoga Text Book

Tiktaka Ghrita
Mahatiktaka Ghrita
Panchatiktaka Guggulu Ghrita
Vrisha Ghrita
Sudarsana Choorna
Tugadi Choorna
Patoladi choorna
Yavanyadi Choorna
Talisapatradi Choorna
Trilavana Pasugandhadi Choorna
Hingu Vachadi Choorna
Vyoshadi Choorna
Karpooradi Choorna
Bala Soolari choorna
Sudha Khandadi Kshara
Dathryarishta
Lohasava
Agasthya Rasayana
Danti Haritakyavaleha
Vyaghryadi Leha
Gandira Rasayana
Swadamshtradi Ghrita
Amrtaprasa Ghrita

Pathya apathya – Yogaratnakara

Wholesome herbs, diet and habits

Rice, green gram, barley, meat of animals of arid, desert-like land mixed with pepper, pointed gourd, bitter gourd etc.

Unwholesome herbs, diet and habits

Oil, sour tasting foods, buttermilk, heavy to digest foods, astringent foods, fatigue, exposure to smoke, anger, sexual intercourse, worry, speaking excessively etc.

Click to Consult Dr Raghuram Y.S. MD (Ayu)