( By The Yoga Institute )

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An Alternative to By-Pass Surgery

'Kayakalpa' is a process by which a person becomes younger. The process of aging depends mainly on atherosclerosis in which the lumen of the arteries is narrowed due to the deposition of the fats in the arterial wall. Hence, if regression of the artherosclerosis can be achieved then one can rightly say that 'Kayakalpa' has taken place from the view point of modern medicine!

The atherosclerosis of the coronary arteries supplying blood to the heart results in Angina in early stage and into heart attack in late stages. It has been shown by modern medicine that regression of the atherosclerosis of the coronary arteries occurs in about three months in 50 percent of the patients of angina and heart attack. This is achieved by controlling various risk factors of heart attack like high blood pressure, diabetes, smoking and especially by lowering blood fats to a level much below their so called normal levels. The cholesterol level in blood is decreased to 180 mg. Per 100 ml. Or less and the triglycerides levels are lowered below the levels of 80 mg./100 ml. The reduction in blood fats levels is obtained by changes in the diet, exercise and weight reduction (if necessary). In some cases drugs are given to achieve very low levels of blood fats. Coronary vasodilators are also given as an important part of the overall treatment.

It is obvious that no specific treatment was given in the above cases for mental stress which is accepted as one of the most important factors of angina and heart attack. As Yoga has best to offer in the treatment of mental stress and as Yoga is based on the principles of proper diet, exercise and life style, a CORONARY CARE CAMP was organised at The Yoga Institute, Santacruz, Bombay. Dr. Jayadeva and Mrs. Hansaben looked after the Yoga aspects and I was fortunate to be connected with the camp as co-ordinator looking after the modern medical aspects.

After the scrutinisation of the applicants, 14 cases of angina and heart attack were included in the coronary care camp. One patient left the camp in between as she had found it psychologically very difficult to stay in the camp. Out of the remaining thirteen cases who could complete the camp, three could not come for follow up. The effect of the coronary camp of the adequately followed up 10 cases are given below. We have been informed that the remaining three cases who could not come for follow up are also doing well.

Benefits of the coronary care camp
Patients and their profiles at the time of joining Camp Symptomatic Improvement
Objective Improvement assessed by Modern Test and procedures
graphy (ECG)
Echocardio- graphy (2 D Echo)*
1. Male, 60 with MI and occasional HBP BetterBetter
2. Male, 65 with MI, Angina & HBPYesSame Same
3. Male, 58 with MI, Angina,HBP & Dia-B Slight
4. Male, 58 with MI, Angina,HBP & Dia YesBetter
5. Male, 63 with MI & HBP YesBetterBetter
6. Male, 61 with MI, Angina & Dia - B SlightSlight
7. Male, 69 with AnginaYesSame
8. Male, 50 with MI and Angina YesBetter
9. Male, 57 with MI, occasional HBP & Dia-B Same
10. Female, 50 with Angina & HBP YesBetter Same

Note : *2D Echocardiography checks the health of heart's wall and heart's valves by using ultra sound waves.

DIA= Diabetes Dia-B= Borderline Diabetes
M.I.= Myocardial Infarction
Damaged Heart following Coronary Artery Disease
H.B.P= High Blood Pressure (Hypertension)

Out of the 10 patients, eight had heart attack in the past and two had angina without any history of heart attack in the past. Of the eight patients of heart attack, five had angina which had developed after the heart attack. In 5 out of the 10 cases, there was history of established hypertension. Moreover, in 2 other patients there was a history of transient rise of blood pressure. Three patients never had any high blood pressure. Four out of 10 had history of high blood sugar levels and out of these, three had only borderline blood sugar levels. Apart from clinical examination, X-ray chest, ECG and blood fats (Serum cholesterol, triglycerides, HDL cholesterol), Stress test was done in four patients. In three of these, the test was positive, while in one case of anterosepatal infarct, the test was negative. Gated blood pool studies were available in four and all showed coronary heart disease. Coronary angiography result was available in one patient and it showed involvement of left anterior descending and circumflex artery block of significant degree. 2D Echocardiogram was done during the coronary camp and was repeated after three months. This was done to obtain a direct evidence of the benefit or otherwise arising out of the camp.

During the camp, the patients stayed in the campus for 7 days. They followed a pattern of unhurried regular lifestyle. They spent about three hours in Yoga which included about 45 minutes of walk. For about an hour a day they were informed about Yoga and its principles and they were informed about the art of mental relaxation. Their diet was simple and nourishing, low in fats, salts and spices. For about an hour a day, the patients were informed about the risk factors of heart attack, about high blood pressure, about the importance of blood fat levels, about weight reduction and about the regression of atherosclerosis. In other words, the patients were told how to prevent heart attack and how to reverse the process of artherosclerosis in the coronary arteries.

All the ten patients were well motivated. Only one could not follow diet, as he had excessive bleeding per rectum. Remaining nine patients could follow either walking exercise or yogasana or both regularly. All of them made a positive approach to change the life style.

At the end of three months, six out of seven who had angina showed significant improvement in the symptoms. The three asymptomatic patients had definite improvement in their approach to the disease and could relax much better.

In three out of five cases, ECG showed improvement. 2D Echo was repeated in all the ten cases and it showed a significant improvement in 4, slight in 3 and no change in 4.

In conclusion, it was noted that the coronary care camp helped the patients to understand their disease and thereby to take effective steps in a much better way. No patient showed any deterioration. Six out of seven who had angina showed significant improvement. This improvement was supported by the improvement in ECG or ECHO or both in most of the cases.

In spite of the small number of the patients in the study, the results are striking. It indicates that a further study of at least 100 cases should be done to come to definite well supported conclusions.

Yoga has preached its principles for hundreds of years. Modern medicine has been able to prove that these principles are right with the help of modern diagnostic methods. It is possible to improve not only the symptoms of angina by a combined treatment with Yoga and modern medicine, but it has been possible to demonstrate that beneficial changes do occur as supported by ECG and echocardiographic findings. This is an indirect evidence of the regression of artherosclerosis of the coronary arteries or ' Kayakalpa' of the heart.

This combined treatment of yoga and modern medicine should especially be given to those patients of angina and heart attack who are advised coronary by-pass surgery but are unable to undergo the surgery due to financial, psychological or other reasons. Obviously it is the best treatment for those patients in whom surgical risk of by-pass is on the higher side.

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