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Heart Disorders

Heart Disorders

Description

There are many conditions which can cause a disturbance in the normal function of the heart. Among the most common heart disorders are angina pectoris, arrhythmia, congestive heart failure and coronary heart disease.

Angina pectoris

Characterized by a squeezing, crushing, or burning tightness or pain in the chest which radiates to the left shoulder blade, left arm, or jaw. It usually indicates coronary artery disease.

Classification is often as “stable”, or “unstable”, so that the condition is dormant, with onset at predictable levels of exertion (e.g. halfway up the stairs) or unpredictable, respectively.

The pain typically lasts for only 1-20 minutes. It is caused by an insufficient supply of oxygen to the heart muscle which may be a result of atherosclerosis or a spasm of a coronary artery. Stress, anxiety and high blood pressure are usually accompany angina (see Atherosclerosis).

Arrhythmia

Refers to an irregularity or disturbance in the rate or rhythm of the heartbeat. There are many causes of arrhythmias including electrolyte imbalances, disturbance in electrical impulse to the heart as a result of a prior heart attack, infection, rheumatic heart disease, congenital heart defect and abnormalities due to atherosclerosis. Arrhythmias can vary in intensity from no noticeable symptoms to severe distress, which may even result in death.

Congestive heart failure

Refers to a clinical syndrome in which the heart fails to pump blood sufficiently to maintain the circulation of blood, with the result being congestion and fluid retention in the tissues.

Congestive heart failure is usually a consequence of atherosclerosis, hypertension, aortic and mitral valvular disease, or a congenital malformation. Symptoms first become apparent at night. Usually the patient with congestive heart failure will experience shortness of breath when lying down. To reduce this effect, they will often employ several pillows to prop themselves up or else sleep in a chair.

In its full-blown stage, there is severe shortness of breath, pitting edema, enlargement and tenderness of the liver, engorged neck veins, and fluid accumulation in the lungs (see hypertension, atherosclerosis).

Coronary heart disease

Or ischemic heart disease is a result of atherosclerosis of the arteries supplying blood and oxygen to the heart.

Over 33% of all deaths in the United States are the result of coronary heart disease. Heart attacks or myocardial infarctions alone account for over 20% of all deaths and are the result of an interruption of blood and oxygen supply to the heart muscle. Several factors can be responsible for this including blockage of the artery by an atherosclerotic plaque or thrombi, or spasm (see atheroclerosis).

Causes

Angina pectoris

Insufficient blood to the heart

One variant, Prinzmetal's angina, is caused by a spasm of the coronary artery.         

Arrhythmia

Physiological or pathological disturbance in discharge of impulses
Congenital infarction
Hypertrophy of muscle fiber
Degeneration of conductive tissue

Congestive heart failure

Arteriosclerosis
Atherosclerosis
Congenital malformations
Hypertension
Hypertrophy of heart
Infection

The cardiac interstitium is populated by nonmyocyte cell types including transcriptionally active cardiac fibroblasts and endothelial cells which are the source of many components of the cardiac extracellular matrix.

The renin-angiotensin-aldosterone system plays a role in the abnormal deposition of extracellular matrix in the cardiac interstitium during the development of inappropriate cardiac hypertrophy and failure.

The extracellular matrix is a dynamic entity and alterations in its structure result in heart dysfunction. such as: diabetes, hypertension, cardiac hypertrophy and congestive heart failure.

Congestive heart failure is a frequent complication of massive obesity and a major cause of death.

Gender is a consideration. The manner in which studies of coronary heart disease have been conducted primarily with male subjects, has given a skewed perception that coronary artery disease is a male affliction. In fact it is the leading cause of death among women, especially elderly women. Many risk factors are similar among men and women (high blood pressure, cholesterol and cigarette smoking) however, women have the greater incidence of diabetes mellitus, congestive heart failure, and hypertension as they become older.

Congestive heart failure ( as well as diabetes mellitus, hepatic dysfunction, and other end-organ insufficiency) is a manifestation of hemochromatosis; an iron metabolism disorder that causes progressive damage to the liver, pancreas, heart and other organs. Hemochromatosis is five times more frequent in males than in females.


Heart attack

Occlusion of a coronary artery by a thrombus or fatty deposit

Signs & Symptoms

Symptoms can vary according to which side of the heart is affected.

Angina pectoris

Steady, severe pain in the heart and continuing down the left arm
Anxiety
High blood pressure
Pale face
Sweaty brow

Classification is often as “stable”, or “unstable”, so that the condition is dormant, with onset at predictable levels of exertion (e.g. halfway up the stairs) or unpredictable, respectively.

Arrhythmia

Varies in intensity from mild, asymptomatic to severe, which can require resuscitation

Congestive heart failure

Breathlessness
Cerebral and renal insufficiencies
Chest pain
Engorgement of veins
Fatigue
Hypotension
Nausea
Palpitations
Slowed mental response
Tender liver
Weight gain


Weight loss is a frequent sequela in patients with congestive heart failure and is commonly referred to as cardiac cachexia. This weight loss is unlike that seen in simple starvation because it preferentially involves the depletion of lean body mass. Increased respiratory rate accompanying congestive heart failure may be responsible for increased energy requirements.

Growth in children with congenital heart disease (CHD) is often compromised.

Endothelial dysfunction, as evidenced by a diminished response to such vasodilators as acetylcholine, is well defined in patients with heart failure.

Nutritional Supplements

Structure & Function:
        Cardiovascular Support &
        Circulatory Support


---------------------------------
General Supplements
---------------------------------

Adult
Brewer's yeast*
Chromium 200 - 300 mcg
Copper 2 - 3 mg
CoQ10 30 mg
EPA 4 - 10 g
L-Carnitine
Magnesium 400 - 800 mg
Selenium 100 - 300 mcg
Vitamin C1000 - 3000 mg
Vitamin E 200 - 600 IU
Policasanol*
Luteolin*



* Please refer to the respective topic for specific nutrient amounts.

Note: All amounts are in addition to those supplements having a Recommended Dietary Allowance (RDA). Due to individual needs, one must always be aware of a possible undetermined effect when taking nutritional supplements. If any disturbances from the use of a particular supplement should occur, stop its use immediately and seek the care of a qualified health care professional.

Cardiomyopathy

Aspartic acid*
Carnitine*
CoenzymeQ10*
Copper*
Fatty acids*
        n-6 sunflower oil*
        n-3 fish oil (EPA)*
Magnesium*
Potassium*
Selenium deficiency*
Taurine*
Vitamin D*
Vitamin E*
Zinc*

* Please refer to the respective topic for specific nutrient amounts.

Discussion:

Carnitine has antiarrhythmic effects.

CoenzymeQ10 may be especially useful for diabetics with ventricular premature beats. It has also demonstrated efficacy for supraventricular tachyarrhythmias.

Polyunsaturated fatty acids have also been beneficial, reducing arrhythmias induced by ischemia.

Magnesium and taurine affect membrane excitability, normalizing flux in and out of the heart muscle cell. Loss of taurine may lead to arrhythmia.

Magnesium supplementation may prevent and correct arrhythmias. (However, serum magnesium may appear within normal limits!) Magnesium may also act as a buffer against digitalis toxicity, preventing arrhythmias.

Potassium may also be functionally inadequate but serum levels show it to be within the normal range. Magnesium and potassium may be most effective when administered together. In the form of magnesium and potassium aspartate, they also contribute aspartic acid. Aspartic acid, paradoxically, speeds the therapeutic benfits of digitalis while reducing its maintenance dosage and toxic effects.

Vitamin D may facilitate calcium transport and deficiency can bring on sick sinus syndrome.


Increased zinc:copper ratio (due to copper deficiency) may cause atrial or ventricular dysfunction and sudden death.

Dietary Considerations

Angina Pectoris

A low fat diet and nutritional supplements to promote fatty acid metabolism form the mainstay of the diet program. Magnesium is a key mineral for the proper functioning of the heart muscle.

Carnitine improves fatty acid utilisation, lowers cholesterol and triglyceride levels, reduces the production of toxic fatty acid metabolites and increases energy production in the mitochondria (energy producing units within the cells of the heart).

Energy production is also improved by supplementing with pantethine (which works together with coenzyme A) and Coenzyme Q10 (ubiquinon).

Typical antioxidant recommendations usually comprise: vitamins A (as beta carotene), C and E.


Cardiomyopathy

Rule out food and chemical sensitivities.


Congestive heart failure

This disorder necessitates following a Mild Sodium Restriction Diet or Moderate Sodium Restriction Diet or Severe Sodium Restriction Diet. These diets decrease water retention, lowers blood volume, and thus improves the heart's ability to pump blood. Meals for individuals with congestive heart failure should be small, but frequent, to avoid fatigue.


Heart attacks

Heart attacks leave individuals weak and critically ill. When the individual is finally able to take food orally, a Clear Liquid Diet is usually prescribed.

After one or two days, the individual is allowed more calories (750 to 1,250 kilocalories) and more food. A Mechanical Soft Diet is usually prescribed at this time. Caffeinated foods and beverages, such as coffee, are normally omitted and meals are served at a temperature prescribed by the physician; extreme temperatures of food are avoided because they can cause cardiac arrhythmias. The physician will determine when the individual can go back to normal eating patterns, although permanent alterations in the diet may have to be made concerning salt or cholesterol consumption.

Homeopathic Remedy

Heart disorders - see coronary heart disease

Tonic for heart

Crataegus Hawthorn tinct. - 30C

Angina

1.* Haematoxylin campechianum 15C
2. Glonoinum tinct. 30C
3. Latrodectus mactans - 15C
4.** Cactus grandiflorus - tincture
5.* Spigelia - 15C

Treatment Schedule

Doses cited are to be administered on a 3X daily schedule, unless otherwise indicated. Dose usually continued for 2 weeks. Liquid preparations usually use 8-10 drops per dose. Solid preps are usually 3 pellets per dose. Children use 1/2 dose.

Legend

X = 1 to 10 dilution - weak (triturition)
C = 1 to 100 dilution - weak (potency)
M = 1 to 1 million dilution (very strong)
X or C underlined means it is most useful potency
Asterisk (*) = Primary remedy. Means most necessary remedy. There may be more than one remedy - if so, use all of them.

References
Boericke, D.E., 1988. Homeopathic Materia Medica.

Coulter, C.R., 1986. Portraits of Homeopathic Medicines.

Kent, J.T., 1989. Repertory of the Homeopathic Materia Medica.

Koehler, G., 1989. Handbook of Homeopathy.

Shingale, J.N., 1992. Bedside Prescriber.

Smith, Trevor, 1989. Homeopathic Medicine.

Ullman, Dana, 1991. The One Minute (or so) Healer.

Herbal Approaches

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Herbs
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General:

Broom
Cola
Hawthorn berries
Motherwort

Angina Pectoris:

Hawthorn berries have been popular in Europe and phytopharmacy is enjoying renewed popularity in the U.S.

Menopausal heart problems:

Phytoestrogens seem to be benficial, both lowering the risk and possibly delaying the onset of heart problems. Dong quai and Vitex are popular choices.

Tachycardia (German Commission E)

Indian Snakeroot
Motherwort herb

Cardioactive ingredients

Several herbs with cardioactive ingredients have been listed by Newall:

HerbEffect
BroomAlkaloids, depressant effect
CalamusAntiarrhythmic
CereusTyramine, cardiotonic
ColaCaffeine
ColtsfootCalcium channel blocker
Devil's ClawActivity, in vivo
FenugreekActivity, in vitro
FigwortActivity, in vitro
FumitoryAlkaloids,
GingerActivity, in vivo
Ginseng, PanaxActivity, in vivo
GoldensealBerberine, cardioactive alkaloid
HawthornTyramine, activity, in vivo
Horehound, WhiteActivity, in vivo
Lime FlowerActivity with excessive ingestion
MateCaffeine
MistletoeViscotoxin, negative inotropic effect
MotherwortActivity, in vitro
ParsleyApiole poisoning in high doses
Pleurisy RootCardenolides, activity, in vivo
Prickly AshInteraction with Na, K, ATPase
QuassiaActivity, in vitro
Shepherd's PurseActivity, in vitro
SquillCardiac glycosides
Wild CarrotDepressant activity, in vivo



Hawthorn leaf and flower is approved by the German Commission E as a cardiac preparation. It enjoys major sales as a phytomedicine in the German market, over $29 million.

Motherwort herb is also recommended for cardiac symptoms.

References:

Blumenthal, M (Ed.): The Complete German Commission E Monographs: Therapeutic Guide to Herbal Medicines. American Botanical Council. Austin, TX. 1998.

Newall CA, Anderson LA, Phillipson JD. Herbal Medicines: A Guide for Health-care Professionals. London: The Pharmaceutical Press, 1996:21,45,63,282.

Aromatherapy - Essential Oils

Angina:

Aniseed Essence,
Caraway Essence,
Orange Essence (Blossom).

Cardiac Fatigue:

Aniseed Essence,(Borneo) Camphor Essence,
Garlic Essence.



Palpitations ( due to nervousness):

Aniseed Essence,Caraway Essence,
Orange Essence (Blossom),Peppermint Essence,
Rosemary Essence.



Tachycardia:

Garlic Essence,Ylang-Ylang Essence.



Related Health Conditions

Anxiety
Arteriosclerosis
Atherosclerosis
Coronary heart disease
Diabetes mellitus
Hypertension
Obesity
Smoking
Stress
Thrombosis

Abstracts
References