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Management Of Ischeamic Heart Disease
in the Light Of Advia-e-Qalbia
Presented byDr Mohd Shahid
P G ScholarD/O Moalajat
NIUM Bangalore
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Summary Introduction Definition Classification AnatomyPathologyFactors responsible for IHD
Primary prevention Etiopathogenesis Clinical features Line of Management Treatment
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“Heart is a miracle organ that starts working as soon as 21st day of conception in mother’s womb and goes on till the last breathes of life. It keeps pumping the blood to the cells of human body, spending sleepless nights and days i.e. lifetime. However, even the importance of heart is countless; we often get casual about our heart”.
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IntroductionCardiovascular diseases (CVD) are
responsible for nearly 50% (17.3 million of deaths due to noncommunicable diseases (NCDs).
Out of the 17.3 million deaths, heart attacks and strokes account for 7.3 million and 6.2 million respectively.
Projected estimates reveal that in 2030 coronary heart disease and cerebrovascular disease will continue to be the leading causes of the global disease burden.
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Cont....An action plan for implementation of a Global
Strategy for prevention and control of NCDs including CVD was endorsed by the World Health Assembly in 2008.
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DefinitionIHD is define as acute or chronic form of
Cardiac disability arising from imbalance between the Myocardial supply and demand for oxygenated blood
Ischemia results when there is an imbalance between myocardial oxygen supply and demand
Since narrowing or Obstruction of the Coronory artirial system is the most common cause of Myocardial anoxia, “ CAD” used as synonym
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CORONARY ARTERY DISEASEASYMTOMATIC STATE ANGINA PECTORISMYOCARDIAL INFARCTIONCHRONIC ISCHAEMIC HEART
DISEASESUDDEN CARDIAC DEATH
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Facts and figures MI occurs every 2 mins in UKAccount for 100,000 deaths annually Cardiovascular death accounts for 40% all
deaths under the age 75 yrs Major cause of cardiac arrest Survival to discharge of all rhythm cardiac
arrests is 10.7%
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Mechanisms of ischaemia Ischaemia – disturbance in myocardial
oxygen supply and demand
Impaired coronary artery blood flowAtherosclerosis Coronary artery spasmTachycardia – shortened diastole
Impaired oxygen delivery Hypoxia Anaemia
Increased cardiac work
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Anatomy 1. Aorta
2. Right Coronary Artery
3. Left Anterior Descending Artery
4. Circumflex Coronary Artery
5. Left main stem
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Atherosclerosis
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Risk FactorsFixed
AgeMale sexGenetic factorFamilial and
racial factors
Modifiable
SmokingHypertensionHyperlipidaemiaDiabetes mellitusObesity AlcoholSedentary
lifestyle
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Circumflex artery obstruction Lateral infarction ECG changes leads I, AVL and V4-V6 20% cases
Left anterior descending obstruction Anterior infarction ECG changes V1-V4 50% cases – most likely to cause left
ventricular dysfunction
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Right coronary artery obstruction Inferior infarction ECG changes in II, III & AVF 30% cases
Posterior myocardial infarction Usually right coronary artery but may be
circumflex ST depression in anterior leads
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Clinical FeaturesProlonged cardiac
pain; chest, throat, arms, epigastrium or back
Anxiety and fear of impending death
Nausea and vomiting
BreathlessnessSyncope/Collapse
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HISTORYIt was amazing to find that, the knowledge
of heart and its function was much clear to
the man in 4000 B.C itself (Ahmed W et all. Cardiology
with special reference to Al-qanoon and advia wal qalbiya. JISHIM 2007-2008, 6-7.)
There is an abundant literature on
anatomy, physiology and cardiac diseases
described by our Atibba
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contd…
Jalinoos (Galen) is the first to explain the
circulation and Ibn Sina has explained the
same in his book ‘Al Qanoon fil tib’.
Jalinoos and Ibn sina - there are 3
ventricles in animal or human heart.
They also stated that there is a pore in the
ventricular septum.
These theories were discarded by Ibn Nafis.
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Ibn Nafis He has clearly described the mechanism of
Pulmonary circulation.
He stated that there are only 2 ventricles and
also there is no pore b/w the two vetricles.
Right side is filled with blood.
Left side is filled with blood and Vital spirit. (Husain F et
al. Ibn al-Nafis, A biographical sketch of discoverer of pulmonary and coronary circulaion.. JISHIM 2003,1)
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Concept of cardiac disorders
Based on the following fundamentals….
Sue Mizaj
1) Sue mizaj sada(extrinsic factor)
2) Sue mizaj maddi (altered
humour)
3) Sue mizaj Mufrad
4) Sue mizaj Murakkab
Amraaz-e-Trkeeb
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Cont.....Amraaz-e-TafarrukAuraam (Inflammatory disease)Amraaz-e-Shirki
“If the altered temperament becomes irreversible then treatment becomes almost impossible”. (Ibne Sina)
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Co-Relation of IHD disease in Our System
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KhafqaanKhafqaan Qalb ki harkat-e-tabayi mai zyadti ka
naam hai (kitab-ul-teseer )Us harkat ka naam hai, jo Qalb ke andar gair
tabayi tor par ho (Moalajat-e-Buqratiya)Qalb ka Khafqaan ek aisi harkat ka naam hai jo
Qalb mai tezi ke saath musalsal Ikhtilaaj ke mushaaba hoti hai (Kitab-ul-Haavi V-7)
Qalb ki gair tabayi harkat, jo Ikhtilaaj se mushaaba hoti hai. Aur is ka sabab har aisi cheez hai jis se Qalb ko Aziyat pohunchti ho. (Akseer-e- Azam)
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AsbaabKhafqaan ka sabab saare badan ka Imtila
hai. Jis ki wajah se Qalb Iztarabi aur Ikhtilaaji harkat karne lagta hai. Taake taklif ya Raghon ki tangi door kar sake
Baaz aukaat Qalb ki Raghon haad Khilt-e-Suadavi jama (Accumulate) ho jane ki wajah se (Kitab-ul-teseer )
Qalb ke andar siyah gaadhe khoon ki wajha se hota hai, jo jigar ke andar behta hai (Kitab-ul-Haavi V-7)
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Asbaab cont…..Qalb ko Aziyat pohunchane wale asbab
1. Sue Mizaj Qalb2. Qalb ki ghilaaf ki wajha se3. Qalb ke qaribee Aaza ki Msharikat se a) Maida/Stomach b) Dimaagh/Brain c) Jigar/Liver d) Riya/Lungs e) Tamam hijab
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Asbaab cont….. f) Miraaq g) Ama/Intestine h) Reham/Uterus i) tamam badan/ full bodyKhilti MaddaGhair Khilti MaddaWaram(Inflammation)Tafarruk-e-Ittisaal
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Asbaab cont…..
Sudda
Asbab-e-gharibaQalb ki badhi hui hissZoef-e-Qalb
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Types of Khafqaan 1. Khafqaan Damvi2. Khafqaan Safravi3. Khafqaan Balgami4. Khafqaan Suadavi5. Khafqaan Reehi
6. Khafqaan Suddi
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Khafqaan Suddi Qalb ki gair tabayi harkat, jo Ikhtilaaj se mushaaba hoti hai aur is ka
sabab koi sudda hota hai
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Advia e Qalbia
The drugs which are used in the treatment of
Amraz e Qalb are …
Mufarreh
Muqawwie Qalb
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مفرح .
یہ عربی لفظ ہے جو فرحت سے ماخوذ ہے
پیدا کرنے والی چیز ۔ انبساط :لزت و لغوی تعریف
:ان دواوءں کو کہتے ہیں جو روح کی غیرطبعی حالت کو اصطلاہی تعریفکا سبب بنتی ہیں ۔ انبساط درست کرکے فرحت و
بعض قوتوں میں لذت کا احساس اس وقت ہوتا ہےجب غیر طبعی حالت ان سے زاءل ہوجاتی ہے۔
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قلب مقوی معتدل کرے کہ ایسا مزاج کو اسکے ءاور قوام عضو ہے جو دواء وہ دراصل
مواد جو اس عضوء کی طرف انصباب کرنے والے ہوں انکو روکے، یا فضول
آاتے ہوں انکو روکدے، یا اس دواء کا مزاج ایسا معتدل آافات اس عضوء پر جو
ہو کہ اس اعتدال کی وجہ سے عضوء کی تبرید میں تسخین اور تسخین میں
تبرید پیدا ہوجیسے گل مختوم، تریاق اور روغن
گل وغیرہ۔
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Drugs mentioned which lower the hyperlipidaemia…..
Garlic(lahsan)
Tinospora cordifolia
(Gilo)
Terminalia arjuna
(Arjun)
Ocimum sativum(Tulsi)
Curcuma longa (Haldi)
Hypolipidemic activity
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علاج اصولSabab ka izala karen
Agar sirf sue mizaj hai to
taadeel se hi kaam lenSue mizaj maddi hai to tanqiya kare
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نسخہ Nuskha baraye Khafqaan SuddiTukhm kasooss, tukhme badranjboya,
shahtra, badiyan har ek 7 mashaBadranjboya, gule surkh, aftimoon har ek
9 mashaBisfaij, daronaj akrabi, har ek 4 mashaTukhm qurtum 1 tola Mawiz munaqqa 3 tolaGule gaouzaban 5 masha, sab ko josh de
kar gul qand 4 tola shamil kar ke 2 hafte tak istemaal karaen.
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Cont...Ishaal ke liye;Gule surkh 1.5 tolaBarge sana 2 tolaRevand khatai 9
mashaSheer khasht 4 tola Turanjabeen 3 mashaKhiyar shambar 7
tolaGulab ek botal
Sharbat-e- Ilahi Alvi khan 3 tola
Sharbat warde mukarrar halelji 3 tola
Roghan badam 7 masha, nuskhe mai zyada kar k pilaye
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Cont...Kamil tanqie k baad taadil ke liye Khamira Gauzaban, arqe guzar ke sath pilaye
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THANK YOU..!!!!