Atherosclerosis Health Dictionary

Thickening and hardening of the arteries with loss of elasticity. While the most common cause is atherosclerosis, it is of gradual onset on old age, diabetes, kidney disorders, syphilis, lead or mercurial poisoning, and certain chronic infections. Treat as for: ATHEROSCLEROSIS. ... arteriosclerosis

A cramp-like pain that occurs in the legs on walking. It may cause the sufferer to limp or, if severe, stop him or her from walking. The usual cause is narrowing or blockage of the arteries in the legs due to ATHEROSCLEROSIS: smoking is a contributary factor. Intermittent claudication occurs when a person has to stop every so often to let the pain – caused by the build-up of waste products in the muscles – to subside. The condition may be improved by exercise, for example, for an hour a day (resting when the pain starts). Pentoxifylline, a vasodilator, may help, as may CALCIUM-CHANNEL BLOCKERS. Patients must avoid all tobacco products.... claudication

A degeneration of arterial walls into fatty tissue by soft waxy material which accumulates in arteries and eventually causes blockages. There is evidence that atheroma starts in childhood. Even children killed accidentally often have fatty deposits in the aorta at post-mortem.

Cause: chiefly high intake of fat meat, milk and dairy products. Atherosclerosis is the hardening process that takes place where calcium is deposited in the arteries. See: HYPERLIPIDAEMIA. ... atheroma

A term applied to rapid contraction or TREMOR of muscles, and especially to a form of abnormal action of the heart muscle in which individual bundles of ?bres take up independent action. It is believed to be due to a state of excessive excitability in the muscle associated with the stretching which occurs in dilatation of the heart. The main causes are ATHEROSCLEROSIS, chronic rheumatic heart disease and hypertensive heart disease (see HEART, DISEASES OF). Fibrillation is distinguished as atrial or ventricular, depending on whether the muscle of the atria or of the ventricles is affected. In atrial ?brillation, the heartbeats and the pulse become extremely irregular, both as regards time and force; when the atrium is ?brillating there is no signi?cant contraction of the atrial muscle but the cardiac output is maintained by ventricular contraction. In ventricular ?brillation there is no signi?cant contractile force, so that there is no cardiac output. The commonest cause is myocardial infarction. Administration of DIGOXIN, timolol or verapamil may restore normal rhythm, and in some patients, CARDIOVERSION – a controlled direct-current electric shock given via a modi?ed de?brillator placed on the chest wall – is e?ective.... fibrillation

The narrowing of the blood vessels in the legs and, less commonly, in the arms. Blood ?ow is restricted, with pain occurring in the affected area. If the blood supply is seriously reduced, GANGRENE of the tissues supplied by the affected vessel(s) may occur and the limb may need to be amputated. The common cause is ATHEROSCLEROSIS which may be brought on by HYPERTENSION, excessively fatty diet, poorly controlled DIABETES MELLITUS or smoking – the latter being the biggest risk factor, with 90 per cent of affected patients having been moderate to heavy smokers. Stopping smoking is essential; adequate exercise and a low-fat diet are important measures. Surgery may be required.... peripheral vascular disease

Stroke, or cerebrovascular accident (CVA), is sudden damage to BRAIN tissue caused either by a lack of blood supply or rupture of a blood vessel (see ISCHAEMIC STROKE). The affected brain cells die and the parts of the body they control or receive sensory messages from cease to function.

Causes Blood supply to the brain may be interrupted by arteries furring up with ATHEROSCLEROSIS (which is accelerated by HYPERTENSION and DIABETES MELLITUS, both of which are associated with a higher incidence of strokes) or being occluded by blood clots arising from distant organs such as infected heart valves or larger clots in the heart (see BLOOD CLOT; THROMBOSIS). Hearts with an irregular rhythm are especially prone to develop clots. Patients with thick or viscous blood, clotting disorders or those with in?amed arteries – for example, in SYSTEMIC LUPUS ERYTHEMATOSUS (SLE) – are particularly in danger of having strokes. Bleeding into the brain arises from areas of weakened blood vessels, many of which may be congenital.

Symptoms Minor episodes due to temporary lack of blood supply and oxygen (called TRANSIENT ISCHAEMIC ATTACKS OR EPISODES (TIA, TIE)) are manifested by short-lived weakness or numbness in an arm or leg and may precede a major stroke. Strokes cause sudden weakness or complete paralysis of the muscles controlled by the part of the brain affected, as well as sensory changes (e.g. numbness or tingling). In the worst cases these symptoms and signs may be accompanied by loss of consciousness. If the stroke affects the area of the brain controlling the larynx and throat, the patient may suffer slurring or loss of speech with di?culty in initiating swallowing. When the face is involved, the mouth may droop and the patient dribble. Strokes caused by haemorrhage may be preceded by headaches. Rarely, CVAs are complicated by epileptic ?ts (see EPILEPSY). If, on the other hand, numerous small clots develop in the brain rather than one major event, this may manifest itself as a gradual deterioration in the patient’s mental function, leading to DEMENTIA.

Investigations Tests on the heart or COMPUTED TOMOGRAPHY or ultrasonic scans (see ULTRASOUND) on arteries in the neck may indicate the original sites of distantly arising clots. Blood tests may show increased thickness or tendency to clotting, and the diagnosis of general medical conditions can explain the presence of in?amed arteries which are prone to block. Special brain X-rays show the position and size of the damaged brain tissue and can usually distinguish between a clot or infarct and a rupture of and haemorrhage from a blood vessel in the brain.

Management It is better to prevent a stroke than try to cure it. The control of a person’s diabetes or high blood pressure will reduce the risk of a stroke. Treatment with ANTICOAGULANTS prevents the formation of clots; regular small doses of aspirin stop platelets clumping together to form plugs in blood vessels. Both treatments reduce the likelihood of minor transient ischaemic episodes proceeding to a major stroke.

Once the latter has occurred, there is no e?ective treatment to reduce the damage to brain tissue. Function will return to the affected part of the body only if and when the brain recovers and messages are again sent down the appropriate nerves. Simple movements are more likely to recover than delicate ones, and sophisticated functions have the worst outlook. Thus, movement of the thigh may improve more easily than ?ne movements of ?ngers, and any speech impairment is more likely to be permanent. A rehabilitation team can help to compensate for any disabilities the subject may have. Physiotherapists maintain muscle tone and joint ?exibility, whilst waiting for power to return; occupational therapists advise about functional problems and supply equipment to help patients overcome their disabilities; and speech therapists help with diffculties in swallowing, improve the clarity of remaining speech or o?er alternative methods of communication. District nurses or home helps can provide support to those caring for victims of stroke at home. Advice about strokes may be obtained from the Stroke Association.... stroke

Insufficient blood supply to a specific organ or tissue. It is usually caused by disease of the blood vessels, such as atherosclerosis, but may also result from injury, constriction of a vessel due to spasm of the muscles in the vessel wall, or inadequate blood flow due to inefficient pumping of the heart. Symptoms depend on the area affected.

Treatment may include vasodilator drugs to widen the blood vessels or, in more severe cases, an angioplasty or bypass operation.... ischaemia

The term given to an area of atherosclerosis. The plaques are symptomless until they are large enough to reduce blood flow or until the surface of a plaque is disturbed, causing thrombosis. Plaques in coronary arteries cause coronary artery disease.... plaque

Narrowing of the coronary arteries, which supply blood to the heart, leading to damage or malfunction of the heart. The most common heart disorders due to coronary artery disease are angina pectoris and myocardial infarction (heart attack). The usual cause of narrowing of the arteries is atherosclerosis, in which fatty plaques develop on the artery linings. The vessel can become totally blocked if a blood clot forms or lodges in the narrowed area. Atherosclerosis has many interrelated causes including smoking, a high-fat diet, lack of exercise, being overweight, and raised blood cholesterol levels. Other factors include a genetic predisposition and diseases such as diabetes mellitus and hypertension.

The first symptom of coronary artery disease is frequently the chest pain of angina. Treatment is with drugs such as glyceryl trinitrate and other nitrate drugs, beta-blockers, calcium channel blockers, potassium channel activators, and vasodilator drugs. If drug treatment fails to relieve the symptoms, or there is extensive narrowing of the coronary

arteries, blood flow may be improved by balloon angioplasty or coronary artery bypass surgery.... coronary artery disease

(Linn. f.) Willd.

Family: Mimosaceae.

Habitat: Drier regions of India, particularly Punjab, Madhya Pradesh, Uttar Pradesh, Bihar, Andhra Pradesh, Orissa and Rajasthan.

English: Cutch tree, Catechu.

Ayurvedic: Khadira, Kadara, Somavalka, Gaayatri, Dantdhaavan, Kantaki, Raktasaara (heartwood extract).

Unani: Khair, Kaat, Katthaa (heartwood extract).

Siddha/Tamil: Karunkaali (bark), Kalippakku, Kadiram. Katthakkaambu, Kaasukkatti (heartwood extract).

Action: Cutch from wood— powerful astringent (in urinary and vaginal discharge), antidiarrhoeal, haemostatic; used for treating excessive mucous discharges, haemorrhages, relaxed conditions of gums, throat and mouth, stomatitis, irritable bowel; also used as an antileprotic drug.

Along with other therapeutic applications, The Ayurvedic Pharmacopoeia of India indicates the use of dried pieces of heartwood in inflammations, skin diseases and urinary disorders, recommends its use as a blood purifier, in diseases caused by lipid disorders.

Cutch (the concentrated extract) contains tannins 2-20%, catechin 2533%, phlobatannins including cate- chutannic acid 20-50%; flavonoids including quercetin, quercitrin, fisetin; gums, resins, pigments. The gum from A. catechu is a good substitute for Gum arabic.

Seed extract—hypoglycaemic to normal albino rats, but not effective in diabetic rats. The saline extract of seeds shows leuco-agglutinating activity against leukaemic cells. It agglutinates white cells from patients with different types of leukaemia. The activity is inhibited by simple sugars. Root extract shows antibacterial and fungi- cidal activity.

The heartwood contains a hepato- protective principle—cyanidanol.

Astringent and antibacterial properties of catechu result from its high tannin content.

Gambrine in pale catechu shows hy- potensive effects.

Fisetin in black catechu and (+)- catechin in black and pale catechu may protect against liver damage; (+)- catechin is also thought to protect against experimentally induced ulcers in animals; (+)-catechin (cianidanol) is associated with fatal anaemia. Methyl- catechin, one of the major metabolites of (+)-catechin, inhibits the binding of monocytes to vascular endothelial cells; thus, the catechin found in catechu may reduce atherosclerosis. (Natural Medicines Comprehensive Database, 2007.)

Dosage: Heartwood—20-30 g for decoction. (API Vol. I.)... acacia catechu

Garlic (Allium sativum).

Plant Part Used: Bulb.

Dominican Medicinal Uses: The bulb is traditionally ingested raw for high blood pressure, upper-respiratory infection, common cold, flu-like symptoms and cough, and the alcohol extract is taken internally for sinusitis. The bulb skins are traditionally prepared as a tea and taken internally for indigestion and gastro-intestinal complaints.

Safety: The bulb is generally regarded as safe for human consumption. Reported adverse effects include skin burns due to topical application (especially in children with prolonged exposure). Adverse effects associated with internal use include halitosis, body odor, gastrointestinal irritation, constipation, headache, nausea, fatigue and vertigo.

Contraindications: Not to be taken at therapeutic doses for 10 days prior to surgery due to antiplatelet activity and risk of excessive bleeding. The bulb is contraindicated during lactation.

Drug Interactions: Chlorzoxazone: garlic may reduce drug metabolism. Indomethacin and NSAIDs: risk of excessive bleeding. Protease inhibitors: reduced blood levels. Drugs metabolized by cytochrome P450 2E1: garlic may inhibit efficacy. Forskilin: garlic may potentiate antiplatelet activity.

Clinical Data: The following effects have been investigated in human clinical trials: treatment of atherosclerosis, common cold, coronary artery disease, hyperlipidemia, hypertension and unstable angina pectoris.

Laboratory & Preclinical Data: The following biological activities have been investigated in laboratory and preclinical studies (in vitro or animal models): antibacterial, anticarcinogenic, antifungal, antihypertensive, antineoplastic, antinociceptive, antioxidant, anti-platelet-aggregant, antithrombic, antiviral and immune enhancing.... ajo

(Bieb.) Desv.

Synonym: A. camelorum Fisch. ex DC.

A. maurorum Medic.

Family: Papilionaceae; Fabaceae.

Habitat: The drier parts of Rajasthan, Gujarat, Punjab and Uttar Pradesh.

English: Camel Thorn, Persian Manna Plant.

Ayurvedic: Yavaasaka, Yavaasa, Yaasa, Duhsparshaa, Duraalab- haa, Kunaashak. Substitute for Dhanvayaasa. Yaasa-sharkaraa (Alhagi-manna).

Unani: Jawaansaa. Turanjabeen (Alhagi-manna).

Siddha/Tamil: Punaikanjuri, Kan- chori.

Action: Laxative, antibilious, diuretic, diaphoretic, expectorant. Leaves—used for fever, headache, rheumatism. Flowers—blood coagulant, used for piles. Alhagi- manna—expectorant, antiemetic, laxative.

Along with other therapeutic applications, The Ayurvedic Pharmacopoeia of India indicates the use of dried whole plant in gout and haemorrhagic disorders.

The aerial parts contain flavonoids, tannins, sterols, triterpenes, saponins and anthroquinones.

The proanthocyanidins derived from the plant possess hypolipidemic and antiatherosclerotic properties. The compounds prevented an increase in rat serum cholesterol and triglycerides, and they decreased the manifestation of atherosclerosis.

A polymeric proanthocyanidin, extracted from the plant, improved energy metabolism and increased the work capacity in rats.

Ethanolic extract of the aerial parts produced positive inotropic effect on rabbit heart.

Dosage: Whole plant—20-50 g for decoction. (API Vol. II.) Decoction—50-100 ml. (CCRAS.)... alhagi pseudalhagi

A technique by which narrowing or blockage of an artery (see ARTERIES), vein (see VEINS) or a section of the gastrointestinal tract is bypassed using surgery. Arterial blockages – usually caused by ATHEROSCLEROSIS – in the carotid, coronary or iliofemoral arteries are bypassed utilising sections of artery or vein taken from elsewhere in the patient. Tumour growths in the intestines are sometimes too large to remove and can be bypassed by linking up those parts of the intestines on each side of the growth.... bypass operation

Linn.

Family: Liliaceae; Alliaceae.

Habitat: Cultivated as an annual all over the country. The most important onion-growing states are Maharashtra, Tamil Nadu, Andhra Pradesh., Karnataka and Madhya Pradesh.

English: Onion.

Ayurvedic: Palaandu, Durgandh.

Unani: Piyaaz.

Siddha/Tamil: Venkaayam.

Action: Antibiotic, antibacterial, antisclerotic, anticoagulant, anti-inflammatory, antiasthmatic, expectorant, carminative, anti- spasmodic, diuretic, hypotensive, antidiabetic.

Key application: For the prevention of atherosclerosis (German Commission E) and age-dependent changes in the blood vessels, and loss of appetite (WHO).

The official onion bulb of the Pharmacopoeia of the People's Republic of China is a different species, Allium macrostemon Bge., than that of the German Commission E monographs, A. cepa. Chinese onion is used for cough, dyspnoea, angina pectoris and dysentery.

Scallions or Spring Onion of Chinese medicine are equated with Allium fistulosum.

Onion bulbs contain a volatile oil with sulphurous constituents, including allylpropyldisulphide; sulphur- containing compounds, including al- licin, alliin; flavonoids; phenolic acids and sterols.

Hypoglycaemic activity of the onion is attributed to the allylpropyldisul- phide and allicin. Diphenylamine, isolated from mature bulbs, also exhibits potent antihyperglycaemic activity.

Alliin and allicin have an inhibitory effect on platelet aggregation. Antibiotic activity is due mainly to alli-cin.

Regular use of onion (50 g/day) reduces insulin requirement of a diabetic patient from 40 to 20 units a day.

Thiosulphinates, isolated from onion juice, exhibited antiasthmatic activity in vivo.

Dosage: Juice of bulb—10-20 ml. (CCRAS.)... allium cepa

ARTERIES are the blood vessels that convey blood away from the heart to the tissues. The commonest cause of arterial disease is a degenerative condition known as atherosclerosis. Less commonly, in?ammation of the arteries occurs; this in?ammation is known as arteritis and occurs in a variety of conditions.

Atherosclerosis is due to the deposition of CHOLESTEROL into the walls of arteries. The process starts in childhood with the development of fatty streaks lining the arteries. In adulthood these progress, scarring and calcifying to form irregular narrowings within the arteries and eventually leading to blockage of the vessel. The consequence of the narrowing or blockage depends on which vessels are involved

– diseased cerebral vessels cause strokes; coronary vessels cause angina and heart attacks; renal vessels cause renal failure; and peripheral arteries cause limb ischaemia (localised bloodlessness).

Risk factors predisposing individuals to atherosclerosis include age, male gender, raised plasma cholesterol concentration, high blood pressure, smoking, a family history of atherosclerosis, diabetes and obesity.

Arteritis occurs in a variety of conditions that produce in?ammation in the arteries. Examples include syphilis – now rare in Britain

– which produces in?ammation of the aorta with subsequent dilatation (aneurysm formation) and risk of rupture; giant cell arteritis (temporal arteritis), a condition usually affecting the elderly, which involves the cranial arteries and leads to headache, tenderness over the temporal arteries and the risk of sudden blindness; Takayasu’s syndrome, predominantly affecting young females, which involves the aortic arch and its major branches, leading to the absence of pulse in affected vessels; and polyarteritis nodosa, a condition causing multiple small nodules to form on the smaller arteries. General symptoms such as fever, malaise, weakness, anorexia and weight loss are accompanied by local manifestations of ischaemia (bloodlessness) in di?erent parts of the body.... arteries, diseases of

Linn.

Synonym: A. tenuifolius Cav.

Family: Liliaceae.

Habitat: Most parts of the plains from West Bengal westwards to Punjab and Gujarat, as a field weed.

English: Asphodel. Unani: Piyaazi, Khunsaa, Asraash. (Asphodelus tenuifolius Cav. is equated with Shellot, Gandanaa.)

Folk: Bokat.

Action: Seeds—diuretic; applied externally to ulcer and inflamed parts.

Seeds contain an ester, 1-O-17-me- thylstearylmyoinositol. The seed oil yields myristic, palmitic, oleic, linole- ic, linolenic acids, beta-amyrin and beta-sitosterol. The oil, due to its high linolenic content (62.62%), may be of therapeutic value in preventing atherosclerosis.

The mineral elements present in the weed are iron 178.4, zinc 44.5 and copper 6.4 ppm. A triterpenoid, lupeol and quercetin are also present.... asphodelus fistulosus

These drugs reduce the amount of low-density LIPOPROTEINS, which transport CHOLESTEROL and triglycerides (see TRIGLYCERIDE) in the blood, or raise the concentration of high-density lipoproteins. The aim is to reduce the progression of ATHEROSCLEROSIS and therefore help prevent coronary heart disease (see HEART, DISEASES OF). These drugs should be combined with reducing other risk factors for raised lipid concentrations, such as a high-fat diet, smoking and obesity. Lipid-regulating drugs include STATINS, ?brates, anion-exchange resins, and NICOTINIC ACID, which may be used singly or in combination under careful medical supervision (see HYPERLIPIDAEMIA).... lipid-regulating drugs

Linn.

Family: Lauraceae

Habitat: Throughout the greater parts of India.

English: Doddar-Laurel, Love-Vine.

Ayurvedic: Amarvalli, Aakaashbel. (Cuscuta reflexa is also known as Amarvalli.)

Siddha/Tamil: Erumaikkottan.

Action: Astringent, diuretic (given in dropsy and anasarca, also in biliousness, chronic dysentery, haemoptysis and for supressing lactation after still-birth); piscicidal and insecticidal (used as a hair-wash for killing vermin).

The plant contains aporphine alkaloids. calcium, phosphorus, thiamine, riboflavin and niacin; also tocopherols. Nuts, crushed with vinegar and barley flour, are used against indurations of breast. The extract of nuts exhibits possibility of its use as a platelet inhibitor in thrombosis and atherosclerosis. Leaves are inhibitors of pectinolytic enzymes.

American chestnut and European chestnut are equated with Castanea dentata and C. sativa,respectively. Both are used for respiratory ailments.... cassytha filiformis

Mill.

Synonym: C. vulgaris Lam.

Family: Fagaceae.

Habitat: Darjeeling, Khasi Hills, Punjab and Himachal Pradesh.

English: Spanish Chestnut, Sweet Chestnut.

Folk: Singhaaraa (not to be confused with water-chestnut, Tripa natans L.)

Action: Leaves—astringent, antitussive and febrifuge (used for fevers and diseases of the respiratory tract). An infusion is used as a gargle in pharyngitis, proxysmal coughs, catarrh and whooping cough. Nuts—extract, as platelet inhibitor in thrombosis and atherosclerosis.

The leaves contain tannins (8-9%) flavone glycosides, triterpenoids, ursolic acid, lupeol and betulin. Heartwood contains 61.4% tannins and 25.7% nontannins. The wood and bark contain 714 and 8-14% tannins respectively.

Nuts are eaten raw, roasted or boiled like potatoes. Nuts contain protein,... castanea sativa

Linn.

Family: Papilionaceae; Fabaceae.

Habitat: Cultivated in most parts of India.

English: Bengal Gram, Chick pea.

Ayurvedic: Chanaka, Chanakaa, Harimantha, Vajimantha, Jivan, Sakal-priya.

Unani: Nakhud.

Siddha/Tamil: Kadalai, Mookkuk- kadalai.

Action: Antibilious, hypoc- holesteremic, antihyperlipidemic, antistress. Acid exudate from the plant—used in indigestion, diarrhoea, dysentery. Seed coat extract—diuretic, antifungal (externally). Dry leaf—refrigerant.

Supplementation of gram in wheat based diet helps in lysine absorption which is otherwise a limiting amino acid in cereal based diets. Germination improves mineral bioavailability. In germinated gram flour, there is significant increase in nutritional quality of protein and very significant increase in ascorbic acid.

The seeds contain pangamic acid, the stemina building, antistress and antihyperlipidemic principle of gram. Gram is given as preventive diet to atherosclerosis patients because of its rich phosphorus content.

Isoflavones, biochanin A and for- monetin exhibited hypolipidermic activity in rats. Total flavonoids reduced serum and liver cholesterol in rats.

Seeds reduced postprandial plasma glucose in human.... cicer arietinum

Linn.

Family: Iridaceae.

Habitat: Cultivated in Kashmir up to 2,000 m and in Chaubattia in Uttar Pradesh.

English: Saffron, Crocus.

Ayurvedic: Kumkuma, Rudhira, Vadrika, Kaashmira, Kaashmiraka, Vaalhika, Agnishikhaa, Ghrusrrn, Rakta, Kshataja. Keshara (usually Keshara indicates Naagakeshara, Mesuaferrea Linn.)

Unani: Zaafraan.

Siddha/Tamil: Kumgumappoo (dried stigma).

Action: Stigma and style—nervine tonic, sedative, antispasmodic expectorant (in dry cough, whooping cough, bronchitis), stomachic, diaphoretic, emmenagogue.

The Ayurvedic Pharmacopoeia of India indicated the use of the stigma and style in migraine, chronic sinusitis, and in urinary obstruction, inflammation of the urinary tract.

The saffron is used in Chinese medicine for melancholia, depression, shock and menstrual disorders.

Saffron contains a volatile oil composed of terpenes, terpene alcohols and esters. The herb also contains crocin, picrocrocin, crocetin, carotenoids and riboflavin and thiamine.

Preliminary evidence suggests that crocetin may improved atherosclerosis by increasing plasma oxygen diffusion and decreasing cholesterol and triglyceride levels. In addition, cro- cetin binds to albumin, potentially increasing oxygen diffusion and improving atherosclerosis. (Natural Medicines Comprehensive Database, 2007.)

The stigma showed remarkable inhibitory effect on blood coagulation due to the presence of platelet aggregation inhibitor containing adenosine. It accelerated in vitro fibrinolytic activity of urokinase and plasmin.

Small amounts of Saffron stimulate gastric secretion; larger amounts stimulate uterine smooth muscle and exhibit emmenagogue and abortifacient effects.

Saffron extract showed cytotoxic and antimutagenic activity and antitu- mour activity against ascites tumours in mice. Chemical analysis indicated that the naturally occurring crocin may be the active principle responsible for the observed anticancer activity.

A xanthone, carotenoid glycosidic conjugate, mangi-crocin, isolated from saffron, showed significant adapto- genic activity. A natural antioxidant, isolated from saffron stem callus, showed better antioxidant activity than vitamin E. Saffron bulbs are toxic, stigmas in overdoses narcotic.

The dose of stigma and styles at 1.55.0 g is toxic. (Recommended dose : 0.5-1.5 g per day).

Dosage: Dried style and stigma—20-50 mg (API Vol. IV.)... crocus sativus

Linn.

Family: Compositae; Asteraceae.

Habitat: Monastery gardens of Europe. Now cultivated in India.

English: Globe Artichoke.

Unani: Harshaf.

Action: Herb—antitoxic, liver restorative, hypocholesterolaemic. Water soluble extract is used for liver and renal diseases for its cholagogic and choleretic action (flow of bile increases up to 60 per cent). Artichokes assist digestion of fats, are known as diabetic's potato in Europe.

Key application: In dyspeptic problems. (German Commission E.) The British Herbal Pharmacopoeia reported hepatic action.

All parts of the plant contains ses- quiterpene lactone cynaropecrin and inulin. The leaves contain cynarin. Hepatic activity of the leaves is due to polyphenols such as cynarin, caf- feoylquinic acid derivatives and flavon- oids. Cynarin and caffeic acid exhibited hepatoprotective activity in CCl4-treated rats. (A minimum of 1% polyphenols and 0.2% flavonoids in the dried leaves is required for the activity.)

The plant is included in indigenous compound formulations recommended for viral and drug-induced hepatitis. All parts of the plant stimulate digestive secretions, especially bile, and are used for the treatment of gallbladder problems. Plant is used as a diuretic in dropsy. The plant is also used against atherosclerosis and for lowering cholesterol levels.

The extract gave mixed results in preventing alcohol-induced hangover. (CMAJ, 169, 2003, 1269-73; Natural Medicines Comprehensive Database, 2007.)... cynara scolymus

Dandelion tea is an excellent source of vitamins and an unbeatable way to maintain healthy body and mind. About Dandelion tea Dandelion is a perennial yellow plant scientifically called Taraxacum officinale. Itcan be used as a herbal plant but also in the kitchen in many recipes, salads etc. It grows everywhere and it appears in early spring. Its flowers last until late fall. For medical purposes, the young flowers are usually used before flowering along with the root. The flowers are an important source of vitamins (A, B, C and D), minerals (is very rich in potassium) proteins, carbohydrates, and tannins, caffeic acid. The leaves are also important. The root contains a bitter compound - taraxacina - but it is also rich in pectins, sterols, vitamins B1, C and D, inulin, tannin, volatile oils and reshines. You can use the leaves to prepare salads, juices, infusions or tinctures. The roots are mostly used for teas, tinctures and decoction. Dandelion tea is considered an overall tonic with multiple benefits. How to brew Dandelion tea For regular use, you can drink 2 cups of dandelion tea per day. Use 2 teaspoons of dried plant for a hot water cup. Let it infuse for a couple of minutes and then let it rinse. Another way of drinking the dandelion tea is by using small cutted leaves and dried roots. Pour into a container approximately 200 ml of water, add the plant and let it boil. After that, cover the container with something and keep it to infuse for 15 minutes. In the end, filter it and enjoy the tea. You may add some honey or sugar. Benefits of Dandelion tea Dandelion tea has lots of benefits as it is considered one of the healthiest teas. - Dandelion tea is depurative, sudorific and diuretic - Dandelion tea helps to diminish high cholesterol - It promotes gastrointestinal health, enhancing digestion, stimulating the appetite and treating digestive problems such as heartburn or upset stomach - Dandelion tea is suitable in diets or in fighting obesity as it helps the body eliminate water, having a detoxifying role -The tea is considered to be aliver, kidney and gallbladder tonic and it normalizes blood circulation - It is used with success in treating several skin ailments like acne, gout, atherosclerosis, varicose veins - Dandelion tea has an antirheumatic effect and some studies underlined that it also boosts the immunity - Dandelion tea also has a cosmetic  use as it improves skin clarity and cleanses complexion Side effects of Dandelion tea Although dandelion tea has many benefits, it also has several warnings that you should take into consideration. It is not advisable to use the plant after flowering. Dandelion tea can reduce the efficiency of some medicines and may interact with some drugs or other herbs. Avoid combining this tea with antibiotics, garlic, gingko biloba, blood thinners or pain relievers, as a risk of bleeding may arise. Some studies pointed out that those suffering of diabetes and low blood sugar, as well as pregnant women or breastfeeding women should consult their physician before drinking dandelion tea. If you are allergic to daisies, chrysanthemum, chamomile or marigold you may also develop same reaction for dandelion. Some people call dandelion tea the elixir of long life as it brings vitality and makes you strong if you consume it on a regular basis. However, it’s best to keep the moderation and to search for information before you decide to drink it on a regular basis.... dandelion tea

Platelets are the small, rather uniform fragments of large bone marrow cells that aid the blood in coagulation, hemostasis, inflammation, and thrombus formation. Mild subclotting and sticking is a common early condition that can lead to thrombosis, atherosclerosis, and strokes, and can be helped by an aspirin a day, better fat digestion, and Ceanothus.... platelet aggregation

A genetic disorder in which the affected person usually carries an extra chromosome – 47 instead of the usual 46. The extra chromosome occurs in the no. 21 group, hence the disorder is described as trisomy 21. The condition was named after Dr J L H Down, the London doctor who ?rst described it in 1866. The incidence is around one in 600 births. The disorder is characterised by a particular physical appearance and learning diffculties, with the affected individuals having an INTELLIGENCE QUOTIENT (IQ) ranging from 30 to 80 (normal is 100). Most people with the syndrome have eyes that slope up at the outer corners with skin folds that cover the inner ones. The face and features are smaller than normal, while the tongue is larger; the back of the head is ?attened and the hands are usually short and broad. The facial features led to the syndrome being described as ‘mongolism’, a term that is no longer used.

Children with Down’s syndrome are usually friendly and ?t in well with the family. Despite their learning disabilities, some learn to read and, if they have appropriate educational and environmental stimulation, can make the most of their abilities.

A heart defect is present in around 25 per cent of the children at birth, and deafness and acute LEUKAEMIA occur more frequently than in unaffected youngsters. Those with the syndrome are particularly prone to developing ear infections. ATHEROSCLEROSIS often develops early in adults and ALZHEIMER’S DISEASE tends to occur as early as 40 years of age. A friendly home environment helps them to enjoy life, but a few individuals with the syndrome may eventually require institutional care. Improved social and medical care means that many now live until their 60s.

Routine screening tests early in pregnancy, starting with blood analysis but going on if necessary to AMNIOCENTESIS and chorionic villus sampling (see PRENATAL SCREENING OR DIAGNOSIS), can identify fetuses likely to develop the disorder. If a sample of fetal cells con?rms the chromosome defect (triple marker test – see PREGNANCY AND LABOUR), the parents may consider termination of the pregnancy. In the UK, screening is normally o?ered to women over 35 because of their increased risk. When younger parents have a child with Down’s syndrome, the chances of a subsequent child with the disorder are relatively high as it is probable that both parents carry a chromosome abnormality insu?cient to cause ill-health until combined. So they may wish to discuss with their medical advisers the question of further pregnancies.

Parents who have a child with Down’s syndrome will understandably feel a combination of strong emotions, including anger and guilt, and constructive counselling can be valuable. Among societies o?ering advice and support is the Down’s Syndrome Association.... down’s (down) syndrome

The health benefits of fumitory tea have been well-known since ancient times as it has a “bringer of long life” fame. Fumitory was once used as an herb to stop the hiccups and sometimes even as a tool to expel evil spirits. About Fumitory tea Fumitory is an annual, climbing herb native to Eurasia, Australia and North America. Also known as fumaria officinalis, it has slender stems, triangular leaves, limp branches and pinkish flowers with purple or white tops. Fumitory can be found in various forms like tea infusion, tincture, capsules or extract form. Active components include alkaloids (including fumarine and protopine), bitter principles, tannic acid, fumaric acid, mucilage, flavonoids, resin, potassium. For fumitory tea, the above ground parts of the plant are usually used. Brew Fumitory tea To prepare fumitory tea, simply place 1 to 2 tablespoons of dried fumitory herbs in a cup of boiling water. Let it infuse for about 10 to 15 minutes and then you can add milk or natural sweetener to taste. Fumitory tea benefits Fumitory tea has many health benefits as long as you drink up to 3 cups a day. Fumitory Tea may help in the treatment of skin problems such as eczema and acne. It is diuretic, laxative, sedative and a general tonic. It supports liver and kidney treatment and may help in the fight against gallstones. Fumitory tea is used also to treat cystitis, atherosclerosis, rheumatism, arthritis as well as to purify the blood. Fumitory tea side effects Please keep in mind not to associate fumitory tea with drugs, alcohol or some medicines as it can create unwanted interactions. Also, if you are a pregnant or nursing woman and you are planning to have children, it’s best to keep away from this tea. Safety Risk Side effects associated with fumitory include hypotension, increased intraocular pressure, and acute renal failure. When applied externally through eyewashes, fumitory tea, may help in the treatment of conjunctivitis. Fumitory tea is mostly safe for regular use. However, take into consideration the possible side effects and adjust the consumption according to your needs.... fumitory tea

Surgical removal of part or all of a limb. Amputation is necessary if peripheral vascular disease as a result of atherosclerosis or diabetes mellitus has impaired the blood supply to a limb. If blood supply cannot be restored, amputation is carried out to prevent the

development of gangrene. Amputation may also be needed if a limb has been irreparably damaged in an accident.

For some time after amputation, there may be an unpleasant sensation that the limb is still present, a phenomenon known as “phantom limb”. A prosthesis (see limb, artificial) is usually fitted when the stump has healed.... amputation

Gaertn.

Synonym: Phyllanthus emblica Linn.

Family: Euphorbiaceae.

Habitat: Native to tropical Southeast Asia; distributed throughout India; also planted in public parks.

English: Emblic, Indian gooseberry.

Ayurvedic: Aaamalaki, Aaamalaka, Dhaatri, Kaayasthaa, Amoghaa, Amritaphala, Amla, Aaamalaa, Dhaatriphala, Vayasyaa, Vrshya, Shiva, Hattha.

Unani: Aamalaa, Amlaj.

Siddha/Tamil: Nellikkaai, Nelli.

Action: Fruit—antianaemic, anabolic, antiemetic, bechic, astringent, antihaemorrhagic, antidiarrhoeal, diuretic, antidiabetic, carminative, antioxidant. Used in jaundice, dyspepsia, bacillary dysentery, eye trouble and as a gastrointestinal tonic. Juice with turmeric powder and honey is prescribed in diabetes insipidus. Seed—antibilious, antiasthmatic. Used in bronchitis. Bark—astringent. Leaf—juice is given in vomiting.

A decoction of powdered pericarp is prescribed for paptic ulcer.

Key application: As an antacid. (Indian Herbal Pharmacopoeia.).

The fruit is an important source of vitamin C, minerals and amino acids. The edible fruit tissue contains protein concentration threefold and vitamin C (ascorbic acid) concentration 160-fold than those of apple. The fruit also contains considerably higher concentration of most minerals and amino acids than apple.

The fruit gave cytokinine-like substances identified as zeatin, zeatin ribo- side and zeatin nucleotide; suspension culture gave phyllembin. Phyllem- bin exhibits CNS depressant and spasmolytic activity, potentiates action of adrenaline and hypnotic action of Nembutal.

The leaves contain gallic acid (10.8 mg/g dry basis), besides ascorbic and music acid. The methanol extract of the leaves is found to be effective in rat paw inflammation.

The bark contains tannin identified as mixed type of proanthocyanidin.

The fruit contains superoxide dis- mutase 482.14 units/g fresh weight and exhibits antisenescent (anti-aging) activity. Fruit, juice, its sediment and residue are antioxidant due to gallic acid. EtOH (50%) extract—antiviral.

Aqueous extract of the fruit increases cardiac glycogen level and decreases serum GOT, GPT and LDH in rats having induced myocardial necrosis.

Preliminary evidence suggests that the fruit and its juice may lower serum cholesterol, LDL, triglycerides and phospholipids without affecting HDL levels and may have positive effect on atherosclerosis. (Eur J clin Nutr, 42, 1988, 939-944; PhytotherRes, 14, 2000, 592-595.)

An aqueous extract of the fruit has been reported to provide protection against radiation-induced chromosomal damage in both pre-and postirradiation treatment. The fruit is reported to enhance natural killer cell activity and antibody dependent cellular cytotoxicity in mice bearing Dalton's lymphoma ascites tumour. The extract of the fruit and ascorbic acid prevented hepatotoxic and nephrotoxic effects induced by lead and aluminium. The toxicity could be counteracted to a great extent by the fruit extract than by an amount of ascorbic acid alone equivalent to that contained in fruits. (The fruit can be used as a dietary supplement to counteract prolonged exposure to metals in population in industrial areas.)

The fruits are reported to activate trypsin (proteolytic enzyme) activity.

The fruits can be used as coagulant in the treatment of water and can purify low turbidity water.

The fruits can be consumed safely all round the year.

Dosage: Fresh fruit—10-20 g; pulp juice—5-10 ml. (API Vol. I.)... emblica officinalis

The benefits of Chrysanthemum Tea were discovered centuries ago by Chinese and Oriental people who used it for medicinal purposes and as a natural coolant. About Chrysanthemum Tea Chrysanthemum Tea is a herbal tea made from Chrysanthemum flowers of the species Chrysanthemum morifolium or Chrysanthemum indicum, which are most popular in Eastern Asia. The chrysanthemum is a leafy plant, adorned with clusters of daisy-like flowers. The plant can be found worldwide. The constituents of chrysanthemum are vitamin C, beta-cartone, calcium, fiber, folacin, iron, magnesium, niacin, potassium and riboflavin. Chrysanthemum tea has a delicate, slightly floral aroma and a light, refreshing taste. How to brew Chrysanthemum Tea To prepare a tasty cup of Chrysantemum tea, it is usually recommended to use around 3 or 5 dried flowers for every 250ml of water. Let the flowers steep in hot water at 90°c in a teapot until the liquid turns light yellow. You can add rock sugar as well, to enhance its flavor. Chrysanthemum tea is slightly yellow in color and has a floral aroma and taste. In Chinese tradition, once a pot of chrysanthemum tea has been drunk, hot water is typically added again over the flowers in the pot (producing a tea that is slightly less strong); this process is repeated several times. Chrysanthemum Tea Benefits Chrysanthemum tea is not very famous amongst herb enthusiasts, and  that is because very few people know about its existence and benefits. Chrysanthemum Tea may help lower blood pressure and consequently, may also help in the treatment of other related ailments like angina and other heart problems. It may also help relieve headaches. Chrysanthemum Tea may help in the treatment of colds, fever and the flu or tinnitus. This type of tea may help in the treatment of skin problems such as acne, boils and sores. Chrysanthemum Tea is believed to contribute in clearing the vision and improving the general eyesight. Chrysanthemum Tea has stimulating property and helps in alerting the senses and rejuvenating the brain. It stimulates all your senses very quickly and also calms down the nerves. Chrysanthemum Tea is drunk or used as a compress to treat circulatory disorders such as varicose veins and atherosclerosis. Chrysanthemum Tea Side Effects There are some side effects associated to the Chrysanthemum tea consumption. In some cases, it may cause contact dermatitis and photosensitivity. Do not associate this tea with other sedatives or high blood pressure medicine as it may intensify the effects of those drugs. Do not take this tea if you are pregnant or breastfeeding. If you take into consideration the precautions above and you do not drink too much of it, you can include Chrysanthemum tea in your healthy lifestyle and enjoy its taste and benefits.... have a cup of chrysanthemum tea

Linn.

Family: Gramineae; Poaceae.

Habitat: Cultivated as food crop in Uttar Pradesh, West Bengal, Bihar, Madhya Pradesh, Rajasthan, Haryana, Punjab, Himachal Pradesh and Jammu and Kashmir.

English: Barley

Ayurvedic: Yava, Hayeshtha, Hayapriya, Shuka-dhaanya, Tiksh- nashuka.

Unani: Barley, Jao Shaeer.

Siddha: Yavam. Saambaluppu (ash).

Action: Barley—nutritive and demulcent during convalescence and in cases of bowel inflammation and diarrhoea. Protects immune system.

The Ayurvedic Pharmacopoeia ofIn- dia recommends barley in urinary disorders, muscular rigidity, chronic sinusitis, cough, asthma, lipid disorder and obesity.

Juice of young barley leaves—7 times richer in vitamin C than oranges, 5 times richer in iron than spinach, 25 times richer in potassium than wheat; high in SOD (superoxide dismutase), an enzyme that slows ageing of cells.

The nutritional quality of the barley depends on beta-glucan fraction of the grain. Beta-glucan-enriched fraction produced cholesterol-lowering effect in hamsters.

Naked barley extracts have been found to selectively inhibit cyclohex- anase activity and may be useful as a therapeutic drug for treating thrombosis and atherosclerosis.

Ethanol extract of young green leaves exhibits antioxidant activity attributed to a flavonoid, 2"-O-glucosyl- isovitexin. It also exhibits antiinflammatory and antiallergic activities. The leaves contain an indole alkaloid, gramine, which exhibits antibacterial properties.

Dosage: Dried fruit—100-200 g. (API Vol. II); dried plant—10-20 g. (API Vol. IV.)... hordeum vulgare

Linn.

Habitat: Cultivated mainly in Madhya Pradesh, Uttar Pradesh, Maharashtra, Bihar and Rajasthan.

English: Linseed, Flax.

Ayurvedic: Atasi, Umaa, Masrnaa, Nilapushpi, Kshumaa.

Unani: Kattan.

Siddha/Tamil: (Seed).

Action: Seed—demulcent, emollient, laxative, antilipidemic, antitussive, pectoral (used in bronchitis and cough). Flowers—used as nervine and cardiac tonic. Oil— used in burns, skin injuries and sores.

Key application: Internally, for chronic constipation, for colons damaged by abuse of laxatives, irritable bowel syndrome, diverticular disease, symptomatic short-term treatment of gastritis and enteritis. Externally, for painful skin inflammations. (German Commission E, ESCOP, The British Herbal Pharmacopoeia.)

The plant contains chlorogenic acid and its isomer. Also present are palmitic, stearic, oleic, linoleic acids, along with amino acids, and sugars. Linseed also contains mucilage (3-10%) in epidermis; fatty oil (30-40%); cyanogenic glycosides (0.05-00.1%) mainly linus- tatin, neolinustatin and linamarin; lig- nans; phenylpropane derivatives including linusitamarin. (Cyanogenic glycosides are not found toxic in therapeutic doses as these are broken down only to a limited extent in the body.)

The seeds are an excellent source of dietary alpha-linolenic acid for modifying plasma and tissue lipids. Flaxseed preparations reduced atherogenic risk in hyperlipemic patients. (Cited in Expanded Commission E Monographs.)

Human studies have indicated Flax- seed's use in atherosclerosis, hyperc- holesterolemia, lupus nephritis, chronic renal diseases and in cancer prevention (active principle: lignan precursor secoisolariciresinol diglycoside). (Sharon M. Herr. Also Am J Clin Nutr, 1999, 69, 395-402.)

The PP glucose response to a 50 g carbohydrate load given as Flaxseed bread was found to be 27% lower when compared with regular white bread.

Taking Flaxseed oil daily for 3 months did not improve symptoms of pain and stiffness in rheumatoid arthritis and no effect was observed on RA, such as C-reactive protein and ESR. (Natural Medicines Comprehensive Database, 2007.)

The water-binding capacity and rhe- ological properties of linseed mucilage resembled those of guar gum.

Dosage: Ripe seed—3-6 g powder. (API, Vol. I.) Flower-bud—3-6 g; oil—5-10 ml. (CCRAS.)... linum usitatissimum

An operation to repair arteries that are narrowed, blocked, or weakened. Arterial reconstructive surgery is most often performed to repair arteries that have been narrowed by atherosclerosis. It is also used to repair aneurysms and arteries damaged as a result of injury. (See also angioplasty, balloon; coronary artery bypass; endarterectomy.)... arterial reconstructive surgery

The deposition of calcium salts in body tissues that is part of the normal process of bone and teeth formation and the healing of fractures.

Calcification also occurs in injured muscles, in arteries affected by atherosclerosis, and when blood calcium levels are raised by disorders of the parathyroid glands.... calcification

The branch of surgery concerned with the heart and blood vessels.

Cardiovascular surgery includes operations to prevent or repair damage caused, for example, by congenital heart disease (see heart disease, congenital), atherosclerosis, or a myocardial infarction (heart attack).

Procedures include heart valve surgery, coronary artery bypass, and heart transplant.... cardiovascular surgery

Any disease affecting an artery in, and supplying blood to, the brain: for example, atherosclerosis (narrowing of the arteries) or defects or weaknesses in arterial walls causing aneurysm (a balloon-like swelling in an artery).

The disease may eventually cause a cerebrovascular accident, which commonly leads to a stroke.

Extensive narrowing of blood vessels throughout the brain can be a cause of dementia.... cerebrovascular disease

Either of the 2 main arteries that supply the tissues of the heart with oxygen-rich blood. These are

known as the left and right main coronary arteries and arise directly from the aorta. The term coronary artery is also applied to any of the arteries that branch off from the main coronary arteries, such as the left circumflex artery and the left anterior descending artery. Blockage of a coronary artery as a result of atherosclerosis can lead to myocardial infarction.

(See also coronary artery disease.)... coronary artery

Diseases developing during a person’s lifetime may be the result of his or her lifestyle, environment, genetic factors and natural AGEING factors.

Lifestyle While this may change as people grow older – for instance, physical activity is commonly reduced – some lifestyle factors are unchanged: for example, cigarette smoking, commonly started in adolescence, may be continued as an adult, resulting in smoker’s cough and eventually chronic BRONCHITIS and EMPHYSEMA; widespread ATHEROSCLEROSIS causing heart attacks and STROKE; osteoporosis (see BONE, DISORDERS OF) producing bony fractures; and cancer affecting the lungs and bladder.

Genetic factors can cause sickle cell disease (see ANAEMIA), HUNTINGTON’S CHOREA and polycystic disease of the kidney.

Ageing process This is associated with the MENOPAUSE in women and, in both sexes, with a reduction in the body’s tissue elasticity and often a deterioration in mental and physical capabilities. When compared with illnesses described in much younger people, similar illnesses in old age present in an atypical manner

– for example, confusion and changed behaviour due to otherwise asymptomatic heart failure, causing a reduced supply of oxygen to the brain. Social adversity in old age may result from the combined effects of reduced body reserve, atypical presentation of illness, multiple disorders and POLYPHARMACY.

Age-related change in the presentation of illnesses This was ?rst recognised by the specialty of geriatric medicine (also called the medicine of ageing) which is concerned with the medical and social management of advanced age. The aim is to assess, treat and rehabilitate such patients. The number of institutional beds has been steadily cut, while availability of day-treatment centres and respite facilities has been boosted – although still inadequate to cope with the growing number of people over 65.

These developments, along with day social centres, provide relatives and carers with a break from the often demanding task of looking after the frail or ill elderly. As the proportion of elderly people in the population rises, along with the cost of hospital inpatient care, close cooperation between hospitals, COMMUNITY CARE services and primary care trusts (see under GENERAL PRACTITIONER (GP)) becomes increasingly important if senior citizens are not to suffer from the consequences of the tight operating budgets of the various medical and social agencies with responsibilities for the care of the elderly. Private or voluntary nursing and residential homes have expanded in the past 15 years and now care for many elderly people who previously would have been occupying NHS facilities. This trend has been accelerated by a tightening of the bene?t rules for funding such care. Local authorities are now responsible for assessing the needs of elderly people in the community and deciding whether they are eligible for ?nancial support (in full or in part) for nursing-home care.

With a substantial proportion of hospital inpatients in the United Kingdom being over 60, it is sometimes argued that all health professionals should be skilled in the care of the elderly; thus the need for doctors and nurses trained in the specialty of geriatrics is diminishing. Even so, as more people are reaching their 80s, there seems to be a reasonable case for training sta? in the type of care these individuals need and to facilitate research into illness at this stage of life.... medicine of ageing

Linn.

Synonym: P. communis Huds.

Family: Rosaceae.

Habitat: Cultivated in Kashmir, Himachal Pradesh and Kumaon.

English: Prune.

Ayurvedic: Aaruka (Prunus domestica var. insititia). Aaluubukhaaraa.

Unani: Aaluuchaa.

Siddha/Tamil: Alpagada-pungam.

Action: Fruit—refrigerant, laxative, nutritive. Improves haemoglobin levels in iron deficiency. Promotes excretion of excess calcium by the kidneys. An adjuvant for atherosclerosis and arthritis. Root—astringent.

The fruit pulp contains about 44% sugar and malic acid as major constituents. Kernel contains fixed oil about 45% and amygdalin and benzoic acid among others.

The crude extract of the fruit was found effective in controlling centrally induced emesis in dogs. The action was comparable to that of Metoclopramide (Maxolon) and chlorpro- mazine (Largactil).... prunus domestica

A major heart operation to bypass narrowed or blocked coronary arteries using additional blood vessels (such as a mammary artery) to improve blood flow to the heart muscle. This operation is used when symptoms of coronary artery disease have not been relieved by drugs or balloon angioplasty.

Before surgery, sites of blockage in the arteries are identified using angiography. In some cases, minimally invasive surgery can be used, avoiding the need to stop the heart and use a heart–lung machine during the operation. The long term outlook after a bypass is good, but the grafted vessels may also eventually become blocked by atherosclerosis.... coronary artery bypass

Narrowing or blockage of one of the coronary arteries by a thrombus (blood clot), depriving a section of the heart muscle of vital oxygen. In most cases, the thrombus forms in a blood vessel already narrowed by atherosclerosis. Sudden blockage of a coronary artery causes an acute myocardial infarction (heart attack).... coronary thrombosis

An operation to remove the lining of an artery affected by atherosclerosis, restoring normal blood flow. Endarterectomy is used to treat cerebrovascular disease and peripheral vascular disease. The procedure can be performed endoscopically (see endoscopy) or by open surgery.

New lining grows in the artery within a few weeks of surgery.

When narrowing is widespread, arterial reconstructive surgery may have to be performed.... endarterectomy

Roxb.

Family: Liliaceae.

Habitat: Assam, Khasi and Garo Hills, eastwards to upper Burma, Indo-China and southern China.

Ayurvedic: Dweepaantara-Vachaa, Chobachini (bigger var.).

Action: Roots—used for syphilis, venereal diseases and sores, as a blood purifier.

Astilbin, 3-O-caffeoyl-shikimic, fer- ulic, palmitic, shikimic and succinic acids; engeletin, isoengeletin; glucose; daucosterol, beta-sitosterol, stigmas- terol are major constituents of the root.

Crude saponins, isolated from the plant, produced preventive effect on cholesterol-fed atherosclerosis in quails.

Ayurvedic: Maitri.

Unani: Ushbaa (wild species).

Folk: Ghot-vel (Maharashtra).

Action: Roots—used as a substitute for Hemidesmus indicus. Used for venereal diseases, urinary infections, rheumatism. Also used for dysentery. (S. perfoliata Lour., synonym S. prolifera Roxb. is used as a substitute for S. ovalifolia.)... smilax glabra

The popular term for atherosclerosis.... hardening of the arteries

The most common form of heart disease, in which narrowing or obstruction of the coronary arteries, usually by atherosclerosis, results in a reduced blood supply (see coronary artery disease).... heart disease, ischaemic

One of a group of proteins that transport lipids in the blood. High levels of high density lipoprotein can help protect against atherosclerosis. (See also fats and oils; low density lipoprotein.)... high density lipoprotein

Metabolic disorders that are characterized by high levels of lipids in the blood. Hyperlipidaemias may be inherited or associated with another disorder, such as hypothyroidism, diabetes mellitus, kidney failure, or Cushing’s syndrome. They may also be a result of use of corticosteroid drugs. Hyperlipidaemias are associated with atherosclerosis and coronary artery disease.The signs depend on the type of hyperlipidaemia and may include fatty nodules in the skin or over joints, and a white line around the rim of the cornea.

Diagnosis depends on blood tests.

Treatment aims to reduce blood lipid levels, usually by a low-fat diet and lipid-lowering drugs.... hyperlipidaemias

Kudzu Tea has been used for many years in traditional Chinese medicine for treating various health conditions. Kudzu herb grows in different regions of Japan, China, parts of Asia and southeastern parts of the United States. These regions are typically mountains, roadsides, fields or thin forests. The constituents of kudzu are responsible for improving blood circulation along the coronary arteries. These are mainly isoflavones such as daidzin, daidzein, glycosides and puerarin. How To Make Kudzu Tea You can make Kudzu Tea either from the leaves or roots of kudzu. To make Kudzu Tea from leaves you will need to boil Kudzu Tea leaves in water for about 15 minutes. Then let the mix steep for about 5 minutes and, using a strainer to catch the kudzu leaves, pour the tea into your cup. If you want you can sweeten it with sugar or honey. However, in traditional Chinese medicine it is used more often Kudzu Tea made with kudzu roots. To make it, you will need to brew black or oolong tea and after that, add a handful of kudzu roots. Let the whole mix steep for about 10 minutes and then enjoy! Kudzu Tea Benefits The most common and popular benefit of Kudzu Tea is suppressing the craving for alcohol. For people who find themselves consuming alcohol and drink also Kudzu Tea, they may not suffer from hangovers as bad as they normally do. But Kudzu Tea has many other health benefits:

• Kudzu Tea helps enhancing the blood flow to the brain for those who suffer from atherosclerosis.
• Alleviates muscle pain especially in the neck and back areas.
• Alleviates some menopausal symptoms.
• Improves cardiovascular health.
• Helps treating headaches and dizziness.

Kudzu Tea Side Effects

• Pregnant and breastfeeding women should not drink Kudzu Tea or any other herbal tea without consulting their doctor first.
• Kudzu might slow blood clotting and may interfere with cardiovascular treatments.
• Kudzu Tea may affect blood sugar levels in people with diabetes.

In conclusion, you can say that Kudzu Tea has more heath benefits than side effects. Just remember not to drink too much kudzu tea since overconsumption can lead to the side effects listed above!... the amazing benefits of kudzu tea

Linn.

Family: Vitaceae.

Habitat: A woody, shrubby vine, cultivated in Punjab, Rajasthan, Delhi, Uttar Pradesh Maharashtra, Karnataka, Andhra Pradesh and Tamil Nadu for edible fruits.

English: Wine Grape, European Grape. (Chinese: P'u-t'ao.)

Ayurvedic: Draakshaa, Go-stani, Mrdvikaa. Dehydrated fruit— Daakh, Munnakaa, Kishmish.

Unani: Angoor. Dehydrated fruit—Daakh, Maweez, Zabeeb, Munaqqaa, Kishmish.

Siddha: Draksha.

Action: Dried fruits, seedless— nourishing and invigorating. Used in prescriptions for cough, respiratory tract catarrh, subacute cases of enlarged liver and spleen; and in alcohol-based tonics (Aasavs).

The Ayurvedic Pharmacopoeia ofIn- dia recommends dried mature fruits (5-10 g) in anaemia, jaundice, dyspepsia, constipation, haemorrhagic diseases, gout, cough, dyspnoea, and alcoholism.

Grape vine contains flavonoids, tannins, tartrates, inositol, carotenes, cho- line and sugars. The fruit contains tar- taric and malic acids, sugars, pectin, tannin, flavone glycosides, vitamins A, B1, B2, C and minerals; anthocyanins in red leaves and red grapes. Antho- cyanins reduce capillary permeability. Red leaves are astringent and anti- inflammatory; an infusion is used for diarrhoea, heavy menstrual bleeding and uterine haemorrhage; also in the treatment of varicose veins and haemorrhoids.

Oligomeric proanthocyanidin extract of the seed is used in atherosclerosis due to its free radical scavenging ability, also in venous insufficiency, night vision, oedema due to injury and post surgery oedema.

Proanthocyanidin extract decreased hepatotoxicity of acetaminophen in mice. Grape polyphenols, extracted from skin and seeds decreased hepatic injury from alcohol, but had no effect on ethanol-induced lipid changes in rats. (Sharon M. Herr.)

Dosage: Dried mature fruits—5-10 g. (API, Vol. III.)... vitis vinifera

Metabolic disorders that result in abnormal amounts of lipids (fats) in the body.

The most common lipid disorders are the hyperlipidaemias, which are characterized by high levels of lipids in the blood and can cause atherosclerosis and pancreatitis.

There are also some very rare lipid disorders due solely to heredity, such as Tay–Sachs disease.... lipid disorders

A group of drugs used to treat hyperlipidaemia.

These drugs help to prevent, or slow the progression of, severe atherosclerosis and coronary artery disease.

The most commonly used types are statins and fibrates.... lipid-lowering drugs

One of a group of proteins that are combined with lipids in the plasma. Low density lipoproteins (LDLs) are involved in the transport of

cholesterol in the bloodstream. An excess of LDLs (see hyperlipidaemias) is associated with atherosclerosis. (See also high density lipoprotein.)... low density lipoprotein

(Angina pectoris). A condition where the demand for oxygen by the heart exceeds supply. A syndrome, not a disease entity. Common cause is narrowing of the coronary arteries by atheroma limiting the flow of blood in the heart muscle.

Condition also caused by a spasm in the coronary circulation. ‘Strangling pain in the chest’, lasting 2 to 10 minutes. Aggravated by diabetes, anaemia, goitre, high blood pressure and stress.

Is it angina? Important evidence is the association of the pain with exercise and its relief by rest. Pain is similar to intermittent claudication (pain in the calf muscle). Sense of constriction in front of chest: may radiate to the jaw or left arm.

Atherosclerosis (hardening of the arteries) is caused by cholesterol deposits hindering blood flow. It is the work of the practitioner to unclog blocked arteries where possible.

Phytotherapy may increase exercise capacity, reduce the number of angina attacks, and is known to enjoy a low incidence of unwanted side-effects.

Alternatives. Teas. Chamomile, Hawthorn, Motherwort, Lime Flowers, Hops, Oats (avena), Orange Tree leaves.

Tablets/capsules. Cayenne, Hawthorn, Lobelia, Prickly Ash.

Powders. Formula. Equal parts: Hawthorn berries, Opuntia (Cactus flowers), Mistletoe, Motherwort. Dose: 750mg (three 00 capsules or half a teaspoon) thrice daily.

Liquid extracts: Formula: Equal parts: Cactus, Hawthorn, Prickly Ash. Dose: 1-2 teaspoons. Thrice daily.

Tinctures: Formula. Hawthorn BHP (1983) 30ml; Motherwort BHP (1983) 30ml; Prickly Ash bark BHP (1983) 20ml; Tincture Capsicum Fort BPC 1934: 0.25ml. Dose: 5ml in water thrice daily.

Practitioner. Alternatives:–

1. Tincture Aconite, BPC 1949 : 2-5 drops (0.12 to 0.3ml) when necessary.

2. Liquid extract: Lobelia BHP (1983): 10-30 drops every 20 minutes when necessary.

3. Formula. Tincture Selenicereus grand (preferably fresh plant) 1oz; Tincture Ginger quarter of an ounce. Dose: 15-30 drops every 15 minutes.

4. Formula. Liquid extract: Prickly Ash bark 20ml; Liquid extract: Cactus 20ml. Mix. Dose: 5-20 drops when necessary. (A. Barker, FNIMH)

5. Emergency. Tincture Gelsemium BPC 1973. Dose: 5 drops (0.3ml).

Diet: See: DIET – HEART AND CIRCULATION. Vitamin E reduces the risk of angina. ... angina

Sustained contraction of a muscle. Charley Horse.

Causes: oxygen starvation, lactic acid build-up. A common cause is depletion of salt from excessive sweating. Night cramps may be due to impaired blood supply or mineral deficiency: Calcium, Iron, Magnesium. Spasm takes many forms: writer’s, swimmer’s, pianist’s, harpist’s, trumpeter’s, hornplayer’s or emotional stress due to tightening of the facial muscles (German Chamomile). Athlete’s cramp from mechanical stress may be relieved by Cramp Bark as well as manipulation. Repetitive strain injury (RSI).

Cramp of the heart muscle is known as angina (Cramp Bark, Motherwort). Where due to spasm of blood vessels from atherosclerosis it may take the form of intermittent claudication (Prickly Ash bark, Cramp bark, Nettles, Vitamin E). For cramp in the back (Cramp bark, Ligvites); stomach (Fennel, Cardamoms, Turkey Rhubarb); womb (Squaw vine, Wild Yam, Cramp bark); kidney and bladder (Horsetail); muscles (Devil’s Claw).

Alternatives. Teas. Mild cases. Any one: German Chamomile, Lime flowers, Holy Thistle, Motherwort, Silverweed, Skullcap, St John’s Wort, Betony.

Combination: equal parts, Skullcap, German Chamomile, Motherwort. 1 heaped teaspoon to each cup boiling water; infuse 5-10 minutes. 1 cup thrice daily or as necessary.

Decoction. More severe cases. Any one: Cramp bark, Valerian, Peruvian bark, Wild Yam, Prickly Ash bark.

Tablets/capsules. Black Cohosh, Cramp bark, Prickly Ash bark, Devil’s Claw, Wild Yam, Ligvites. Combination. Equal parts, Butterburr and Cramp bark. Dose: powders 500mg (two 00 capsules or one- third teaspoon thrice daily); Liquid extracts: one 5ml teaspoon. Tinctures: 1-2 teaspoons. Thrice daily or as necessary.

John William Fyfe MD. “After 20 years broken sleep from leg cramps a patient found relief with 15 drops Liquid Extract Black Haw, thrice daily for 3-4 days.” This was used successfully in his practice for over 30 years.

Aromatherapy. Massage oil. 3 drops Marjoram, 3 drops Basil, in 2 teaspoons Almond or other vegetable oil. Or: Cypress oil, Mustard bath for feet.

Diet. See food sources of Calcium, Iron and Magnesium.

Supplements. Daily. B-complex 100mg; B6 100mg; Dolomite tablets (1000mg); Vitamin E (400iu); Vitamin C (2g); Calcium ascorbate (800mg); Magnesium 300mg (450mg, pregnancy). Zinc (25mg).

For cramp of pregnancy – see PREGNANCY. ... cramp

The progressive loss of hearing that occurs with age. Presbyacusis is a form of sensorineural deafness, which makes sounds less clear and tones less audible. People with the condition often find it difficult to understand speech and cannot hear well when there is background noise. Presbyacusis may be exacerbated by exposure to high noise levels, diminished blood supply to the inner ear due to atherosclerosis, and damage to the inner ear from drugs such as aminoglycoside drugs. Hearingaids help most people.... presbyacusis

Premature aging. There are 2 forms of progeria, and both are very rare. In Hutchinson-Gilford syndrome, the premature aging starts at about 4 years old, and many features of old age, including grey hair, balding, sagging skin, and atherosclerosis, have developed by age 10–12. Death usually occurs at puberty. Werner’s syndrome (adult progeria) starts in adolescence or early adulthood and follows the same progression. The cause of progeria is unknown, although it is known that the cells in affected people reproduce far less frequently than those in healthy people.... progeria

A circulatory disorder affecting the fingers and toes that shares the mechanism, symptoms, and signs of Raynaud’s disease but results from a known underlying disorder.

Possible causes include arterial diseases, such as atherosclerosis; connective tissue diseases, such as rheumatoid arthritis; and various drugs, such as beta-blocker drugs.

The disorder is an occupational disorder of people who use pneumatic drills, chain saws, or vibrating machinery; it is sometimes seen in typists, pianists, and others whose fingers suffer repeated trauma.

Treatment is the same as for Raynaud’s disease, along with treatment of the underlying disorder.... raynaud’s phenomenon

Recurrent attacks of blurred or double vision, loss of coordination, or dizziness caused by reduced blood flow to the base of the brain when one arm (usually the left) is moved.

The cause is narrowing of the arteries that carry blood to the arms, usually due to atherosclerosis.

Treatment is by arterial reconstructive surgery.... subclavian steal syndrome

 Sugar diabetes. Chronic disorder of fat, protein and carbohydrate metabolism. A decrease of insulin by the pancreas gives rise to high level blood sugar (glucose) which is eliminated in the urine by the kidneys. With low insulin production the body cannot convert food into energy. In Britain over 30,000 new cases are diagnosed each year. One in five people go blind because of diabetes. The genetic factor is important; it may run in families due to defect in the immune system. Women who have German measles during the first three months of pregnancy can have a child who develops diabetes during adolescence.

Etiology. The more severe form, in younger patients, needs insulin treatment, without which ketosis and diabetic coma are possible. The milder form in older patients can be managed with diet and hypoglycaemic agents. Now considered due to auto-immune attack on Islet of Langerhams cells in pancreas which secrete insulin. “The Pill” often raises blood sugar. Lack of trace minerals (chromium and zinc). Zinc is a component of insulin and Chromium produces enzymes to stimulate metabolism of sugars. Diabetes can cause heart attack, stroke, hardening of arteries, blindness. It is the leading cause of kidney failure and gangrene.

Symptoms. Great thirst. Urine of high specific gravity. Weakness, emaciation, skin ulcers, loss of tactile sensation in the fingertips (Vitamin B6). In men there may be inflammation of the glans penis and in women, itching of the vulvae. Boils are common. In spite of large appetite there may by severe weight loss. Magnesium deficiency.

Diabetics are subject to glaucoma and detachment of the retina. There is a high incidence of cataract of the eye. While surgery may be necessary, effective supportive herbal treatment can do much. Regular visits to the Hospital Specialist help detect in time future eye, kidney and circulation damage.

High fibre, low fat, high carbohydrate. To help control blood sugar a diabetic must avoid sweets.

Exercise lowers blood sugar.

Agents used with some success: Alfalfa, Damiana leaves, Fenugreek seeds, Aloe Vera juice, Dandelion, Fringe Tree, Guar gum, Garlic (anti-diabetic action shown by Dr Madaus, West Germany, 1967), Bilberry berries, Goat’s Rue (dried aerial parts reduce blood sugar BHP (1983), Olive leaves, onions, Nettles, Pipsissewa, White Horehound, Sweet Sumach, Jambul seeds rapidly reduce sugar in the urine. Karela. Gurmar, (Gymnema sylvestre) leaves are chewed in India to reduce sugar in the urine (mild cases). Balsam pear. Bitter melon (Momordica charastia).

Hypoglycaemic herbs can be effective where the pancreas still functions. Type 1 diabetes, suffered by children whose insulin-producing cells have been destroyed and who produce no insulin at all will always require administered insulin. Maturity-onset diabetes (Type 11) occurs in middle life, insulin- production being insufficient. This form is usually associated with obesity for which herbs are helpful.

Diabetics are specially prone to infections; a course of Echinacea at the onset of winter is beneficial. Coronary artery disease is common in diabetics (especially women) who may develop atherosclerosis at an early age. High blood pressure places undue strain upon kidneys which may excrete too much protein (Yarrow, Lime flowers, Hawthorn). Lack of sensation in the feet exposes the subject to unconscious bruising and injury from which septic ulceration may arise (Chamomile foot baths).

Alternatives. Liver herbs work positively on the pancreas. Diabetic cases should receive treatment for the liver also, Dandelion and Fringe Tree being a reliable combination. Dr John Fearn, California (Ellingwood) used Fringe Tree for all his cases of sugar in the urine: 10 drops, Liquid Extract, 4-5 times daily.

Tea. Equal parts: Peppermint leaves, Dandelion leaves, Goat’s Rue leaves. 1-2 teaspoons to each cup boiling water infuse 5-15 minutes. Cup 2-3 times daily.

Teas from any one of the following: Bilberry berries or leaves, Nettles, White Horehound, Alfalfa, Olive leaves.

Decoction. Fenugreek seeds. 2 teaspoons to each large cup water simmered gently 5 minutes. One cup daily, consuming the seeds.

Powders. Equal parts: Sweet Sumach, Jambul seeds, Dandelion. Dose: 750mg (three 00 capsules or half a teaspoon) thrice daily.

Tinctures. Formula. Equal parts: Jambul, Fringe Tree, Goat’s Rue. Dose: 1 teaspoon thrice daily and at bedtime.

Tablets. Dr Alfred Vogel: tablet containing: Bilberry, Kidney Bean, Tormentil, English Walnut leaves, Alfalfa leaves, Cuckoo flowers.

Karela (Momordica Charantia) Hypoglycaemic action gave good results in clinical trials. Daily dose: 50/60ml fresh juice.

Evening Primrose. See entry.

Guar Gum. 5g unit dose sachets (Guarina) containing dispersible granules. This gum has shown beneficial effects for insulin-dependants.

Hypoglycaemics (second degree). Allspice, Bugleweed, Burdock, Ginseng, Lily of the Valley, Wormwood, Nettles.

Diabetic gangrene. Tinctures: equal parts, Echinacea, Thuja. Internally and externally. Internal dose: 30- 60 drops.

Diabetic neuralgia. Cayenne pepper (Capsicum). Frequently successful.

American traditional. It is claimed that 500mg Bayleaf, Cinnamon, Cloves and Turmeric halve the need for insulin in diabetics.

Diet. Dietary treatment has changed over the past few years. Patients are now advised by the British Diabetic Association to eat food rich in complex carbohydrates (starches) and high in fibre as in wholemeal bread, oats and wholegrain breakfast cereals, wholewheat pasta, brown rice, beans and lentils, vegetables and fruit. Fat intake should be carefully watched (lean meat); skimmed milk, polyunsaturated or low-fat cheeses and salad dressings. Certain foods are known to encourage the pancreas to produce more insulin: banana, barley, cabbage, lettuce, oats, olive, papaya, turnip, sweet potato.

Coffee intake should be limited to prevent hypoglycaemic symptoms.

Barley. A study has shown that the use of barley flour as a substitute for wheat in bread helps to control diabetes, in Iraq. (Naismith D, et al, ‘Therapeutic Value of Barley in Management of Diabetes’: Annals Nutr Metab, 35, 61-64 1991)

Supplementation. Vitamins A, B-complex, C, D, E, F. Vitamin B6. Brewer’s yeast. Minerals: Chromium 50mcg; Manganese 15mg; Magnesium 300mg; Zinc 25mg; to normalise glucose metabolism.

Note: Over 400 traditional plant medicines have been documented for diabetes, but few have been evaluated for efficacy. In the undeveloped countries they are chiefly used for non-insulin dependent diabetes. (Diabetes Care, 1989, Sept 12, p553)

Insulin dependents. Whether adults or children, insulin dependents should under no circumstances discontinue insulin injections.

Treatment by or in liaison with general medical practitioner.

Information. British Diabetic Association, 10 Queen Anne Street, London W1M 0BD, UK. Send SAE. ... diabetes, mellitus

Intermittent episodes of dizziness, double vision, weakness, and difficulty in speaking caused by reduced blood flow to parts of the brain. It is usually due to atherosclerosis of the basilar and vertebral arteries and other arteries in the base of the brain. Vertebrobasilar insufficiency sometimes precedes a stroke.... vertebrobasilar insufficiency

Jamaican Ginger. Zingiber officinale, Roscoe. German: Ingwer. French: Gingembre. Spanish: Gengibre. Italian: Zenzero. Arabian: Zengabil. Indian: Alenadu. Malayan: Alia. Chinese: Kan- kiang. Iranian: Zinjabile. Dried rhizome. Keynote: diffusive stimulant.

Constituents: phenolic compounds, gingerols, mucilage, volatile oil.

Action: anti-inflammatory, carminative, antispasmodic, expectorant, vasodilator, anti-cholesterol. Circulatory stimulant not as sharp as Cayenne. Anti-emetic. Diaphoretic. Traditional ingredient in prescriptions to ensure absorption through the stomach to all parts of the body.

Uses: Travel sickness, flatulent colic, irritable bowel and diarrhoea where no inflammation exists; colds and influenza – to promote perspiration and thus reduce body temperature. Cold hands and feet, hypothermia: a pinch of the powder in a beverage sends blood to the surface. Uncomplicated stomach and intestinal problems; appetite loss; hiccups; to promote secretion of gastric juices in the elderly and in achlorhydria. Brain fatigue (with Kola nuts, equal parts). Atherosclerosis and coronary artery disease (diet). Suppressed menstruation from cold. Improves sex life. Loss of appetite. Jet lag, general weakness. Nausea and vomiting. Morning sickness of pregnancy. Sickness of chemotherapy and after surgical operation. Traditionally eaten with raw fish which effectively destroys anisakis larvae and some other parasites.

Preparations: Tea. Quarter to half a teaspoon to each cup of boiling water or domestic tea, freely. Tablets/capsules. Powdered Ginger, quarter to 1g thrice daily.

Weak tincture BP (1973) Dose: one and a half to 3ml.

Strong tincture: 3 to 10 drops in water.

Liniments, for external use.

Contra-indicated in kidney disease. Best taken with food. ... ginger

Eleutherococcus senticosus, Maxim. Part used: root. Believed to be stronger and more stimulating than Panax Ginseng.

Action. Anti-stress, antiviral, adaptogen, aphrodisiac, vasodilator, hypoglycaemic, tonic, adrenal hormone stimulant, anti-toxic activity in chemotherapy. Beneficial for boosting the body’s natural defence system, to resist viruses, free-radical toxins and even radiation. Increases immune resistance.

Uses: Conditions related to stress. Improves capacity for mental and physical exertion, to revitalise a run- down constitution, shingles, myalgic encephalomyelitis (ME), atherosclerosis in heart and arterial conditions, increases cerebral circulation in the elderly, non-caffeine invigorator, depression from overwork, jet-lag, children – classroom stress, recovery from surgical operation, radiation injury, immune stimulant in cancer therapy. To increase fertility. Enables patient to tolerate higher doses of radiation. Counters nuclear reactor leakage. Inhibits HIV-1 replication in cells acutely or chronically infected. Preparations. Miscellaneous products available.

Tea. Quarter of a teaspoon powdered root to each cup boiling water. OR: dissolve 1-2 capsules in cup of boiling water, once daily.

Tablets/capsules. 150mg, one thrice daily.

General uses and contra-indications: see GINSENG (PANAX). ... ginseng - siberian

See: ANEURISM, ANGINA, AORTIC STENOSIS, ARTERITIS, ATHEROSCLEROSIS, ATHLETE’S HEART, ATRIAL FIBRILLATION, BRADYCARDIA, CARDIAC ARREST, CORONARY HEART DISEASE, ENDOCARDITIS, MITRAL STENOSIS, MYOCARDITIS, PALPITATION, PERICARDITIS, SMOKER’S HEART, TACHYCARDIA, THROMBOSIS.

For all heart disorders. Weight reduction, stop smoking. Reduction of excessive physical exertion. Correction of aggravating factors such as anaemia and dietetic tendency to eat too much animal fat. Specific herbal treatment may be taken with profit before surgery (coronary bypass grafts). Cardiac herbs reduce oxygen consumption by the heart muscle (myocardium) by having a beta-blocker-like effect, lowering the heart rate particularly during exercise and reducing systolic blood pressure, thus decreasing the demand for oxygen. ... heart

A disorder that occurs in the transmission of impulses between the atria (upper chambers) and ventricles (lower chambers) of the heart. A blocking of the normal route of electrical conduction through the ventricles not responding to initiation of the beat by the atria. Beats are missed with possible blackouts.

Causes: myocardial infarction, atherosclerosis, coronary thrombosis or other heart disorder.

Symptoms: slow feeble heart beats down to 36 beats per minute with fainting and collapse, breathlessness, Stoke Adams syndrome.

Treatment. Intensive care. Until the doctor comes: 1-5 drops Oil of Camphor in honey on the tongue or taken in a liquid if patient is able to drink. Freely inhale the oil. On recovery: Motherwort tea, freely. OR, Formula of tinctures: Lily of the Valley 2; Cactus 1; Motherwort 2. Mix. Dose – 30-60 drops in water thrice daily. A fitted pace-maker may be necessary.

Spartiol. 20 drops thrice daily. (Klein) ... heart block

A condition in which deposits of yellowish, fatty material develop in various parts of the body, particularly in the skin, internal organs, corneas of the eyes, brain, and tendons. The deposits may occur only in the eyelids (see xanthelasma). A key feature of xanthomatosis is the tendency for fatty material to be deposited in the linings of blood vessels, leading to generalized atherosclerosis. Xanthomatosis is often associated with hyperlipidaemias.

Treatment aims to lower the levels of fats in the blood by means of a diet that is low in cholesterol and high in polyunsaturated fat, and by drug treatment.... xanthomatosis

a disease associated with diffuse atherosclerosis and sloughing of atheromatous plaques in the aorta and main renal arteries. This results in occlusion of smaller arteries and arterioles downstream within the kidney, with ischaemic and inflammatory reactions. This leads to the onset of renal impairment. Precipitating factors include invasive procedures with aortic cannulae, vascular surgery, and therapy with thrombolytics or anticoagulants. Less commonly the condition can occur spontaneously.... atheroembolic renal disease

(hyperlipaemia) n. the presence in the blood of an abnormally high concentration of cholesterol (see hypercholesterolaemia) and/or triglycerides (see hypertriglyceridaemia) in the form of lipoproteins, which predisposes to *atherosclerosis and coronary heart disease. Familial mixed hyperlipidaemia is an autosomal *dominant condition that occurs in 1 in 200 people and in up to 20% of those with early-onset cardiovascular disease. It is marked by elevation of triglycerides, *low-density lipoprotein, and/or *very low-density lipoprotein coupled with a reduction in *high-density lipoprotein.... hyperlipidaemia

Flaxseed. Linum usitatissimum L. German: Flachs. French: Lin. Italian: Lino usuale. Chinese: Hu-ma-esze. Indian: Tesimosina. Arabian: Bazen. Part used: oil from the seeds (Linseed oil), seeds.

Constituents: oil, mucilage, protein.

Action: demulcent, emollient, anti-cough, nutrient body-builder, antispasmodic (stomach and bowel). Source of polyunsaturated fatty acids, mucins and minerals. Expectorant. Bulk laxative and bowel lubricant. Rich in linoleic acid for breaking down cholesterol deposits, and to produce specific types of prostaglandins. Linseed is around six times richer in Omega-3 (the polyunsaturate present in fish oil) than most fish.

Uses: Its healing mucilage is beneficial for inflammation of the digestive and respiratory tracts, and of the gall duct. To soothe irritable mucous membranes. Spasmodic cough, bronchial asthma, bronchitis. To reduce the risk of atherosclerosis and thrombosis. Heart disease. Persistent constipation.

Preparations: Average dose: 3-6 grams or equivalent. Thrice daily.

Tea: 2-3 teaspoons to cupful boiling water; infuse 15 minutes. Drink without filtering, with honey for sweetening if necessary. One-third-1 cup.

Cold tea for stomach disorders: Half a teaspoon crushed Linseed to cup water soaked overnight. Drink next morning. Heat if desired.

Tincture: 1-2 teaspoons in water.

Poultice: Crushed seeds. Half fill small muslin bag with seeds; immerse in boiling water until swollen seeds fill the bag; apply to abscesses, boils, or to relieve chest pain.

Linseed oil. An ingredient of liniments for burns and scalds.

Linusit: organically cultivated golden Linseed.

Diet: 3 tablespoons crushed Flaxseed daily ensures adequate supply of Omega-3 fatty acids, sprinkled on breakfast cereal, or as an ingredient of muesli. Also increase fluid intake.

Capsules. Emulsified Linseed oil. 1,000mg organic cold-pressed Linseed oil: 1-5 daily. (Bio-Care) LION CLEANSING HERBS. Elder leaf 8 per cent, Fennel 18 per cent, Frangula 8 per cent, Ispaghula 8 percent, Mate 8 per cent, Senna leaf 50 per cent. Non-persistent constipation. (Potter’s) ... linseed

Abnormal dilation (ballooning) of an artery caused by the pressure of blood flowing through a weakened area. Aneurysms most commonly affect the aorta and arteries supplying the brain. The most common cause of an aneurysm is atherosclerosis, a condition in which fatty deposits weaken the artery wall. The aorta is the usual site of atherosclerotic aneurysms.

Less commonly, aneurysms may be due to a congenital weakness of the artery walls. Most cerebral aneurysms, known as berry aneurysms because of their appearance, are congenital. Marfan’s syndrome, an inherited disorder in which the muscular layer of the aorta is defective, is often associated with aneurysms just above the heart. The as occurs in poly- artery wall arteritis nodosa.

Most aneurysms are symptomless and remain undetected, but if the aneurysm expands rapidly and causes pain, or it is very large, the symptoms are due to pressure on nearby structures. Aneurysms may eventually rupture, cause fatal blood loss, or, in the case of a cerebral aneurysm, loss of consciousness (see subarachnoid haemorrhage).

In some cases, only the inner layer of the artery wall ruptures, which allows blood to track along the length of the artery and block any branching arteries. There is usually severe pain and high risk of rupture occurring.

Aneurysms sometimes develop in the heart wall due to weakening of an area of heart muscle as a result of myocardial infarction. Such aneurysms seldom rupture but interfere with the pumping action of the heart.

Aneurysms of the aorta may be detected by ultrasound scanning, and cerebral aneurysms by CT scanning or MRI. Angiography provides information on all types of aneurysm. Ruptured or enlarged aneurysms require immediate surgery (see arterial reconstructive surgery). ... aneurysm

An imaging procedure that enables blood vessels to be seen clearly on X-ray film following the injection of a contrast medium (a substance

that is opaque to X-rays). Angiography is used to detect conditions that alter the appearance of blood vessels, such as aneurysm, and narrowing or blockage of blood vessels by atherosclerosis, or by a thrombus or embolus. It is also used to detect changes in the pattern of blood vessels that supply organs injured or affected by a tumour.

Carotid angiography (of the arteries in the neck) may be used to investigate transient ischaemic attacks. Cerebral angiography can be used to detect an aneurysm in the brain or pinpoint the position of a brain tumour. Coronary angiography, often combined with cardiac catheterization, can identify the sites of narrowing or blockage in coronary artery disease. Digital subtraction angiography uses computer techniques to process images and remove unwanted background information.

Angiographic techniques have been adapted to allow certain treatments that, in some cases, eliminate the need for surgery (see angioplasty, balloon; embolization). (See also aortography.)... angiography

a pathological process involved in *atherosclerosis of arteries and vein grafts, and in *restenosis, that may be in response to angioplasty and stent placement. Damage to the endothelium of the artery exposes the underlying smooth muscle cells in the *media to cytokines, growth factors, and other plasma components in the circulation, which results in loss of their contractile characteristics. These abnormal muscle cells migrate to the *intima, where they proliferate and eventually form a thick layer of tissue (neointima), which occludes the artery.... neointimal hyperplasia

n. surgical enlargement of the junction of the femoral artery and its deep branch, a common operation to relieve narrowing by atherosclerosis at this point.... profundaplasty

n. hardening of tissue, usually due to scarring (fibrosis) after inflammation or to ageing. It can affect the lateral columns of the spinal cord and the medulla of the brain (amyotrophic lateral sclerosis or Lou Gehrig’s disease), causing progressive muscular paralysis (see motor neuron disease). It can also occur in scattered patches throughout the brain and spinal cord (see multiple sclerosis) or in the walls of the arteries (see arteriosclerosis; atherosclerosis). See also tuberous sclerosis.... sclerosis

Leakage of blood through the aortic valve (one of the heart valves), resulting in a backflow of blood from the aorta into the left ventricle (the heart’s main pumping chamber). Failure of the aortic valve to close properly may be due to a congenital abnormality in which the valve has 2 flaps rather than 3. The valve leaflets

can be destroyed by infective endocarditis. Aortic incompetence is associated with ankylosing spondylitis, and Marfan’s syndrome. Atherosclerosis may damage the valve, causing a combination of aortic stenosis and incompetence. Aortic incompetence is also found in untreated syphilis, which is now rare.

Aortic incompetence may not cause symptoms and is sometimes found during a routine medical examination. The heart compensates for the backflow of blood into the left ventricle by working harder, which may eventually lead to heart failure; this causes breathing difficulty and oedema (fluid accumulation).

Chest X-ray, ECG, and echocardiography may be carried out to diagnose aortic incompetence. A cardiac catheter is sometimes used to demonstrate the degree of incompetence (see catheterization, cardiac). Heart failure resulting from aortic incompetence can be treated with diuretic drugs. Heart-valve surgery to replace the damaged valve may eventually be necessary.... aortic incompetence

Narrowing of the opening of the aortic valve (one of the heart valves), causing obstruction of blood flow into the circulation. This makes the heart work harder and causes the muscle in the wall of the left ventricle (the main pumping chamber) to thicken. Narrowing of the valve also reduces the amount of blood flowing into the coronary arteries.

The most common cause of aortic stenosis is deposition of calcium on the aortic valve, usually associated with atherosclerosis. Aortic stenosis may also be caused by a congenital abnormality.

Aortic stenosis may not cause symptoms. When symptoms do occur, they include fainting, lack of energy, chest pain on exertion due to angina, and breathing difficulty.

Chest X-ray, ECG, and echocardiography may be carried out to diagnose aortic stenosis.

A cardiac catheter can be used to demonstrate the degree of stenosis (see catheterization, cardiac).

Heart-valve surgery may be needed to widen or replace the damaged valve.... aortic stenosis

Disorders of the arteries may take the form of abnormal narrowing (which reduces blood flow and may cause tissue damage), complete obstruction (which may cause tissue death), or abnormal widening and thinning of an artery wall (which may cause rupture of the blood vessel).

Atherosclerosis, in which fat deposits build up on artery walls, is the most common arterial disease.

It can involve arteries throughout the body, including the brain (see cerebrovascular disease), heart (see coronary artery disease), and legs (see peripheral vascular disease).

Atherosclerosis is the main type of arteriosclerosis, a group of disorders that cause thickening and loss of elasticity of artery walls.

Hypertension is another common cause of thickening and narrowing of arteries, and it increases the risk of a stroke or kidney failure.

Arteritis is inflammation of artery walls that causes narrowing and sometimes blockage.

Aneurysm is ballooning of an artery wall caused by the pressure of blood flowing through a weakened area.

Thrombosis occurs when a blood clot forms in a blood vessel, causing obstruction of the blood flow.

Blockage of an artery by a fragment of blood clot or other material travelling in the circulation is called an embolism.

Raynaud’s disease is a disorder involving intermittent spasm of small arteries in the hands and feet, usually due to cold.... arteries, disorders of

Procedures to bypass the blockage or narrowing of an artery or vein or any part of the digestive system. Arteries can become blocked or narrowed in atherosclerosis. Obstructions can be bypassed using sections of healthy artery or vein from elsewhere in the body or using synthetic tubing. Veins are bypassed most often in patients with diseases of the liver that cause portal hypertension and bleeding oesophageal varices. This kind of bypass is called a shunt. Intestinal bypasses are employed most commonly in patients with cancer in which tumour growth is too extensive to be removed. An obstructed bile duct can be bypassed by constructing a new opening into the digestive tract. (See also coronary artery bypass.)... bypass operations

A fat-like substance that is an important constituent of body cells and is also involved in the formation of hormones and bile salts. Cholesterol in the blood is made by the liver from foods, especially saturated fats, although a small amount is absorbed directly from cholesterol-rich foods such as eggs. High blood cholesterol levels increase the risk of atherosclerosis, and with it the risk of coronary artery disease or stroke. In general, cholesterol transported in the blood in the form of low-density lipoproteins (LDLs) or very low-density lipoproteins (VLDLs) is a risk factor for these conditions, while cholesterol in the form of high-density lipoproteins (HDLs) seems to protect against arterial disease. Blood cholesterol levels are influenced by diet, heredity, and metabolic diseases such as diabetes mellitus, and can be measured by blood tests. Levels below 5.2 mmol/L are acceptable; higher levels may require further tests. Dietary changes can lower cholesterol slightly; drugs such as simvastatin achieve a greater reduction.... cholesterol

A disorder caused by insufficient or absent production of the hormone insulin by the pancreas, or because the tissues are resistant to the effects. Insulin is responsible for the absorption of glucose into cells. Lack of insulin causes high blood levels of glucose, resulting in the passage of large quantities of urine and excessive thirst. Other symptoms are weight loss, hunger, and fatigue. Urinary tract infections may also occur. Lipid (fat) metabolism is affected and small blood vessels degenerate. Undiagnosed diabetes can lead to blurred vision, boils, and tingling or numbness of the hands and feet.

There are 2 main types of diabetes mellitus, both of which tend to run in families. Type 1 (insulin-dependent) diabetes is the less common form of the disorder and usually develops in childhood or adolescence. In this type of diabetes, insulin-secreting cells in the pancreas are destroyed, and insulin production ceases. Type 2 (noninsulindependent) diabetes generally develops gradually, mainly in people over the age of 40. Although insulin is still produced, there is not enough for the body’s needs as the tissues become relatively resistant to its effects. Symptoms may be present in only a 3rd of people with this type of diabetes; it is often diagnosed only when complications occur.

Treatment aims to keep blood glucose as normal as possible. It involves achieving and maintaining a normal weight, regular physical activity, dietary management, and, if necessary, treatments with antidiabetic drugs.

People with type 1 diabetes require regular insulin injections. Carbohydrate intake is spread out over the day, intake of fats should be kept low, and selfmonitoring of blood glucose levels is important. If the glucose/insulin balance is not maintained, hyperglycaemia or hypoglycaemia may develop.

Treatment of type 2 diabetes usually consists of dietary measures, weight reduction, and antidiabetic drugs, often hypoglycaemic drugs such as sulphonylureas. Some people eventually need insulin injections.

Complications of diabetes mellitus include retinopathy, peripheral neuropathy, and nephropathy. Ulcers on the feet are another risk. People with diabetes mellitus also have a greater risk of atherosclerosis, hypertension, other cardiovascular disorders, and cataracts.

With modern treatment and sensible self-monitoring, nearly all diabetics can look forward to a normal lifespan.... diabetes mellitus

Several diseases are linked with diet. Diseases due to a deficiency are rare in developed countries, but many disorders are due partly to overconsumption of certain foods. A diet high in fats may contribute to atherosclerosis and heart disease. A high-fat diet has also been linked with cancer of the bowel (see colon, cancer of) and breast cancer. Obesity increases the risk of many other disorders, including diabetes mellitus and stroke.

Overconsumption of alcohol can lead to various alcohol-related disorders. A high salt intake predisposes a person towards hypertension. Some components of the diet protect against disease. For example, fibre protects against diverticular disease, chronic constipation, and haemorrhoids.

Many people’s diets contain too few natural vitamins. Pregnant women need high intakes of folic acid to reduce the risk of neural tube defects.

Although many illnesses are commonly ascribed to food allergy, it is only rarely that a definite link is proved. (See also nutritional disorders).... diet and disease

The performance of any physical activity that improves health or that is used for recreation or for the correction of physical injury or deformity (see physiotherapy). Different types of exercise have different effects on the body. During aerobic exercise, such as jogging or swimming, the heart and lungs work faster and more efficiently to supply the muscles’ increased demand for oxygen; regular aerobic exercise improves the condition of both the cardiovascular and respiratory systems. Exercises such as weight training increase muscle strength and endurance. Activities such as yoga and pilates improve flexibility.

Regular aerobic exercise usually leads to a reduction in blood pressure. It also results in an increased amount of highdensity lipoprotein (HDL) in the blood, which is thought to help protect against atherosclerosis and myocardial infarction. Exercise can relieve the symptoms of peripheral vascular disease and of some psychological disorders, particularly depression. Regular weightbearing exercise, such as running, increases the density of, and thereby strengthens, the bones. The bone disease osteoporosis is less common in people who have exercised throughout their adult lives.

However, vigorous exercise may cause injury and increase the risk of a heart attack in people who are out of condition.

Professional sportsmen such as footballers have an increased risk of osteoarthritis in later life because of repeated minor damage to the joints.... exercise

Nutrients that provide the body with its most concentrated form of energy. Fats, which are also called lipids, are compounds containing chains of carbon and hydrogen with very little oxygen. Chemically, fats consist mostly of fatty acids combined with glycerol. They are divided into 2 main groups, saturated and unsaturated, depending on the proportion of hydrogen atoms. If the fatty acids contain the maximum possible quantity of hydrogen, the fats are saturated. If some sites on the carbon chain are unoccupied by hydrogen, they are unsaturated; when many sites are vacant, they are polyunsaturated. Monounsaturated fats are unsaturated fats with only one site that could take an extra hydrogen. Animal fats, such as those in meat and dairy products, are largely saturated, whereas vegetable fats tend to be unsaturated.

Fats are usually solid at room temperature; oils are liquid. The amount and types of fat in the diet have important implications for health. A diet containing a large amount of fat, particularly saturated fat, is linked to an increased risk of atherosclerosis and subsequent heart disease and stroke.

Some dietary fats, mainly triglycerides (combinations of glycerol and 3 fatty acids), are sources of the fat-soluble vitamins A, D, E, and K and of essential fatty acids. Triglycerides are the main form of fat stored in the body. These stores act as an energy reserve and also provide insulation and a protective layer for delicate organs. Phospholipids are structural fats found in cell membranes. Sterols, such as cholesterol, are found in animal and plant tissues; they have a variety of functions, often being converted into hormones or vitamins.

Dietary fats are first emulsified by bile salts before being broken down by lipase, a pancreatic enzyme. They are absorbed via the lymphatic system before entering the bloodstream.Lipids are carried in the blood bound to protein; in this state they are known as lipoproteins. There are 4 classes of lipoprotein: very low-density lipoproteins (VLDLs), low-density lipoproteins (LDLs), high-density lipoproteins (HDLs), and chylomicrons. LDLs and VLDLs contain large amounts of cholesterol, which they carry through the bloodstream and deposit in tissues. HDLs pick up cholesterol and carry it back to the liver for processing and excretion. High levels of LDLs are associated with atherosclerosis, whereas HDLs have a protective effect. (See also nutrition.)... fats and oils

A wide range of disorders can disrupt the heart’s action.

In general, genetic factors do not play a large part in causing heart disorders, however they do contribute to the hyperlipidaemias that predispose a person to atherosclerosis and coronary artery disease. Structural abnormalities in the heart are among the most common birth defects (see heart disease, congenital).

Infections after birth may result in endocarditis or myocarditis. Tumours arising from the heart tissues are rare. They include noncancerous myxomas and cancerous sarcomas.

The heart muscle may become thin and flabby from lack of protein and calories. Thiamine (vitamin B1) deficiency, common in alcoholics, causes beriberi with congestive heart failure. Alcohol poisoning over many years may cause a type of cardiomyopathy. Obesity is an important factor in heart disease, probably through its effect on other risk factors, such as hypertension, diabetes, and cholesterol.

The coronary arteries may become narrowed due to atherosclerosis, depriving areas of heart muscle of oxygen. The result may be angina pectoris or, eventually, a myocardial infarction.

Some drugs, such as the anticancer drug doxorubicin, tricyclic antidepressants, and even drugs used to treat heart disease, may disturb the heartbeat or damage the heart muscle.

Many common and serious heart disorders may be a complication of an underlying condition, such as cardiomyopathy or a congenital defect. Such disorders include cardiac arrhythmia, some cases of heart block, and heart failure. Cor pulmonale is a failure of the right side of the heart as a consequence of lung disease.... heart, disorders of

The intestine is subject to various structural abnormalities and to the effects of many infective organisms and parasites; it may also be affected by tumours and other disorders.

Structural abnormalities may be present from birth (congenital) or may develop later. They cause blockage of the intestine (see intestine, blockage of) and include atresia, stenosis, and volvulus. In newborns, meconium (fetal intestinal contents) may block the intestine.

Generalized inflammation of the intestine may result from viral or bacterial infections or from noninfectious causes, as in ulcerative colitis and Crohn’s disease. Gastroenteritis is the term commonly applied to inflammation of the stomach and intestines. Infection encompasses food poisoning, traveller’s diarrhoea, typhoid fever, cholera, amoebiasis, and giardiasis. Intestinal worm infestations include roundworms and tapeworms. Sometimes inflammation is localized, such as in appendicitis and diverticular disease.

Tumours of the small intestine are rare, but noncancerous growths, lymphomas, and carcinoid tumours (causing carcinoid syndrome) occur. Tumours of the large intestine are common (see colon, cancer of; rectum, cancer of). Some forms of familial polyposis may progress to cancer. Impaired blood supply (ischaemia) to the intestine may occur as a result of partial or complete obstruction of the arteries in the abdominal wall (from diseases such as atherosclerosis) or from the blood vessels being compressed or trapped, as in intussusception or hernias. Loss of blood supply may cause gangrene.

Other disorders that affect the intestine include peptic ulcers, diverticulosis, malabsorption, coeliac disease, and irritable bowel syndrome.... intestine, disorders of

Bleeding into the brain from a ruptured blood vessel. It is 1 of the 3 principal mechanisms by which a stroke can occur. It mainly affects middle-aged or elderly people and is usually due to atherosclerosis. Untreated hypertension increases the risk of intracerebral haemorrhage.

The ruptured artery is usually in the cerebrum. The escaped blood seeps out, damaging brain tissue. The symptoms are sudden headache, weakness, and confusion, and often loss of consciousness. Speech loss, facial paralysis, or onesided weakness may develop, depending on the area affected. Surgery is usually impossible; treatment is aimed at lifesupport and the reduction of blood pressure. Large haemorrhages are usually fatal. For the survivor of an intracerebral haemorrhage, rehabilitation and outlook are as for any type of stroke.

intracytoplasmic sperm injection... intracerebral haemorrhage

The cessation of menstruation, which usually occurs between the ages of 45 and 55. The term is usually used to refer to a period of physical and psychological changes that occur as a result of reduced oestrogen production.

Symptoms of menopause include hot flushes and night sweats; vaginal dryness caused by thinning of the vaginal skin; and a decrease in vaginal secretions. The vagina shrinks and loses elasticity, and becomes prone to minor infections. Vaginal dryness may also make sexual intercourse more difficult and painful (see vaginitis). The neck of the bladder and urethra undergo similar changes, which can result in a feeling of needing to urinate frequently.

Psychological symptoms, such as poor concentration, tearfulness, loss of interest in sex, and depression, are also often attributed to the menopause.

Changes in metabolism occur during the menopause but may not cause symptoms until later. Bones become thinner, and osteoporosis may develop. There is also an increased level of fats in the blood, which may cause an increase in atherosclerosis and a higher incidence of coronary artery disease and stroke.

Hormone replacement therapy (HRT) may relieve menopausal symptoms.

reduces the risk of fractures associated with osteoporosis.

However, it has been associated with a slightly increased risk of breast cancer.

For most women, treatment is recommended for a duration of around 10 years.... menopause

Sudden death of part of the heart muscle due to a blockage in the blood supply to the heart. The disorder is popularly known as a heart attack. It is usually characterized by severe, unremitting chest pain. Myocardial infarction is the most common cause of death in developed countries.

Men are more likely to have a heart attack than women, and smokers are at greater risk. Other risk factors include increased age, unhealthy diet, obesity, and disorders such as hypertension and

diabetes mellitus. Atherosclerosis of the coronary arteries is usually a factor.

Symptoms include sudden pain in the centre of the chest, breathlessness, feeling restless, clammy skin, nausea and/or vomiting, or loss of consciousness. Myocardial infarction may cause immediate heart failure or arrhythmias.

Diagnosis is made from the patient’s history and tests including ECG and measurement of enzymes released into the blood from damaged heart muscle.

A myocardial infarction is a medical emergency. Initial treatment may include aspirin, thrombolytic drugs, analgesic drugs, and oxygen therapy. Diuretic drugs, intravenous infusion of fluids, antiarrhythmic drugs, and beta-blocker drugs may also be given. Electrical defibrillation may be used to control severe arrhythmias.

After recovery, preventive measures such as taking more exercise, losing weight, stopping smoking, and dietary changes are recommended.

Statin drugs are usually given to lower blood cholesterol; aspirin or beta-blocker drugs are given to reduce the risk of further attacks.... myocardial infarction

The formation of a thrombus (blood clot) in an undamaged blood vessel. A thrombus that forms within an artery supplying the heart muscle (coronary thrombosis) is the usual cause of myocardial infarction. A thrombus in an artery of the brain (cerebral thrombosis) is a common cause of stroke. Thrombi sometimes form in veins, either just below the skin or in deeper veins (see thrombosis, deep vein).In arteries, thrombus formation may be encouraged by atherosclerosis, smoking, hypertension, and damage to blood vessel walls from arteritis and phlebitis.

An increased clotting tendency may occur in pregnancy, when using oral contraceptives, or through prolonged immobility.

An arterial thrombosis may cause no symptoms until blood flow is impaired.

Then, there is reduced tissue or organ function and sometimes severe pain.

Venous thrombosis may also cause pain and swelling.

Diagnosis is made by doppler ultrasound.

In some cases, angiography or venography may also be used.

Treatment may include anticoagulant drugs or thrombolytic drugs, nonsteroidal anti-inflammatory drugs, and antibiotic drugs.

In life-threatening cases, thrombectomy may be needed.... thrombosis

(TIA) A brief interruption of the blood supply to part of the brain, which causes temporary impairment of vision, speech, sensation, or movement. The episode typically lasts for several minutes or, at the most, for a few hours. TIAs are sometimes described as mini strokes, and they can be the prelude to a stroke.

TIAs may be caused by a blood clot (see embolism) temporarily blocking an artery that supplies the brain, or by narrowing of an artery as a result of atherosclerosis.

After a TIA, tests such as CT scanning, blood tests, ultrasound scanning, or angiography may be needed to determine a cause. In some cases, the heart is studied as a possible source of blood clots. Treatment is aimed at preventing stroke, which occurs within 5 years in up to one third of patients with TIA. Treatments include endarterectomy, anticoagulant drugs, or aspirin.... transient ischaemic attack

n. high *blood pressure, i.e. elevation of the arterial blood pressure above the normal range expected in a particular age group. Hypertension may be of unknown cause (essential hypertension or hyperpiesia). It may also result from kidney disease, including narrowing (stenosis) of the renal artery (*renovascular hypertension), endocrine diseases (such as Cushing’s disease or phaeochromocytoma) or disease of the arteries (such as coarctation of the aorta), when it is known as secondary or symptomatic hypertension.

Complications that may arise from hypertension include atherosclerosis, heart failure, cerebral haemorrhage, and kidney failure, but treatment may prevent their development. Hypertension is symptomless until the symptoms of its complications develop. Some cases of hypertension may be cured by eradicating the cause. Most cases, however, depend upon long-term drug therapy to lower the blood pressure and maintain it within the normal range. The drugs used include thiazide *diuretics, *ACE inhibitors, *calcium-channel blockers, *beta blockers, and *alpha blockers. Combinations of drugs may be needed to obtain optimum control. See also portal hypertension; pulmonary hypertension.... hypertension

impairment of the blood flow to the arteries that supply the small and large intestine. The arteries include the *coeliac axis and the superior and inferior mesenteric arteries. Partial or total occlusion of blood flow may occur abruptly or over a protracted period (acute vs. chronic mesenteric ischaemia). Causes of an acute episode include migration of an arterial blood clot or embolus into the mesenteric vessels, an arterial blood clot in patients with atherosclerosis, profound low blood pressure, or states promoting coagulation. Typically a patient presents with severe abdominal pain, nausea and vomiting, diarrhoea, and rectal bleeding. Rapid diagnosis is essential since impaired intestinal blood flow predisposes to the development of gangrene and necrosis of the bowel. Treatment includes aggressive fluid resuscitation, pain relief, antibiotics, surgical resection of nonviable bowel, and radiological or surgical *revascularization of implicated arteries. In chronic mesenteric ischaemia, abdominal pain precipitated by eating is the main symptom, often accompanied by loss of appetite and marked weight loss.... mesenteric ischaemia

a condition of unknown cause in which the arteries of the fingers are unduly reactive and enter spasm (angiospasm or vasospasm) when the hands are cold. This produces attacks of pallor, numbness, and discomfort in the fingers. A similar condition (Raynaud’s phenomenon) may result from atherosclerosis, connective-tissue diseases, ingestion of ergot derivatives, or the frequent use of vibrating tools. Gangrene or ulceration of the fingertips may result from lack of blood to the affected part. Warm gloves and peripheral *vasodilators may relieve the condition. In unresponsive cases *sympathectomy is of value. [M. Raynaud (1834–81), French physician]... raynaud’s disease