Adjuvant Ayurvedic Management in Coronary Artery Disease with Coronary Microvascular Dysfunction

Summary

This case report describes an integrative management of coronary microvascular disease using Ayurvedic and modern medicine. Ayurvedic interventions, including Panchakarma, improved symptoms. Caution is advised as it is a single case. Rigorous research is crucial to validate findings and investigate the efficacy and mechanisms of such approaches in cardiac disorders.

Abstract

This case study presents a 59-year-old obese, hypertensive female with a 10-year history of Coronary Microvascular Dysfunction and Coronary Artery Disease, presenting with associated symptoms including mild to moderate body aches, pain in the left ankle, and insomnia. Diagnosed with Vataj Hridroga according to Ayurvedic principles, the patient underwent a 14-day inpatient Ayurvedic treatment regimen, followed by 16 weeks of outpatient oral Ayurvedic medications, alongside her existing modern medical prescriptions. The inpatient regimen included daily Panchakarma therapies: Abhyanga and Nadi Swedana for pain and edema; Shirodhara was administered for insomnia. Oral medications, including Simhanada Guggulu, Ajmodadi Churna, Dashmoola Kwatha, and Bramhi Vati, were prescribed. The integrative strategy involved close monitoring by both Ayurvedic and modern medicine physicians, allowing for necessary adjustments to contemporary medication. Significant improvements in the symptoms were observed: leg pain reduced from a baseline score of 6 to 1 by day 16 and resolved by week 16; grade 2 edema resolved by day 16; and insomnia improved, evidenced by a reduction in Pittsburgh Sleep Quality Index score from 16/21 at baseline to 9/21 by both day 16 and week 26. This report highlights the adjunctive role of Ayurvedic interventions in managing associated symptoms in a complex patient with CMVD and CAD, along with relevant risk factors. This protocol emphasizes the strategic integration of Ayurvedic Panchakarma and oral treatments with contemporary medical therapies. Further rigorous research is warranted to elucidate the mechanisms of action and assess the effectiveness of such integrative approaches combining Ayurveda with conventional medicine, particularly in cardiac disorders.

Introduction

Small vessel disease encompasses abnormalities affecting the microvasculature of organs such as the heart, brain, and kidneys¹. When small vessel disease occurs in the heart, it is also referred to as coronary microvascular dysfunction (CMVD)^2,3. While the pathophysiology and diagnosis of coronary artery disease are well-established, coronary microvascular dysfunction remains less understood⁴. The clinical presentation of CMVD can mimic that of coronary artery disease; a key distinguishing feature is the angina without angiographic evidence of atherosclerosis

Protocol

This study was conducted in accordance with the guidelines and Standard Operating Procedures established by the Manjushree Research Institute of Ayurvedic Science, Piplaj, Gujarat, India. The patient, diagnosed with coronary microvascular dysfunction, and coronary artery disease, received treatment after being fully informed about the Ayurvedic Panchakarma procedures, potential risks, and benefits involved. Written informed consent was obtained from the patient prior to the commencement of treatment, as documented by reference number 235/2024, dated February 27, 2024.

1. Medical treatment management

1. The patient&....

Results

In this complicated case of coronary artery disease with cardiac microvascular dysfunction, a treatment protocol was designed to integrate Ayurvedic therapies with modern medicine. This protocol aimed to alleviate specific symptoms: leg pain, insomnia, and edema. To evaluate the treatment's effectiveness, the following assessment tools were employed:
Self-Reported Leg Pain Assessment: To quantify the patient's subjective experience of leg pain.
Edema Assessment: To objectively measure the degree of edema present........

Discussion

This case report presents the symptomatic relief achieved in an elderly female patient with coronary artery disease (CAD) and coronary microvascular dysfunction (CMVD) through an integrative approach. Adjuvant Ayurvedic therapies, including Panchakarma procedures such as Abhyanga, Swedana, and Shirodhara, along with oral Ayurvedic medications, were administered in conjunction with modern pharmacological treatments. This combined regimen led to a notable reduction in the patient's symptoms.

Materials

List of materials used in this article

Name	Company	Catalog Number	Comments
Aegle marmelos	Dishant Ayurvedic Supplier,	k952
Ajamoda	MRIAS Teaching Pharmacy, Piplaj, Gandhinagar
Bacopa monnieri	Dishant Ayurvedic Suppliers	p1032
Sida cordifolia	AVS Pharma Kottakal
Terminalia chebula	Dishant Ayurvedic Supplier,	T4237