Angina – CAM Support Protocol

Angina is a cardiac condition that typically presents as chest pain. The patient may describe the pain in many ways ranging from feeling like there is a heavy weight on their chest or squeezing, burning, or choking pain. Occasionally, referred pain may be present in the arm, neck, or jaw. There are three types of angina: stable angina (most common), prinzmetal variant angina, and unstable angina. Any of these types of angina can decrease cardiac efficiency and may lead to sudden cardiac arrest (Banasik and Copstead, 2019).

In addition to following a CAM protocol, the patient should be seen by a physician to determine if pharmaceuticals or other interventions are needed. CAM protocols should focus on improving the cardiac function of the heart by improving energy metabolism and blood supply in the heart.

Nutritional Supplementation:

Patients may require antioxidant supplementation to improve prevention of nitrate tolerance and impact lesion activity. Some supplements to use are carnitine, pantethine, coenzyme Q10, vitamins E and C, magnesium, and arginine. Suggested dosage according to Pizzorno and Murray (2013) is: Vitamin C: 500 – 1500 mg/day, Vitamin E: 200 – 400 IU a day, CoQ10: 150 – 300 mg/day, L-Carnitine: 500 mg three times per day, Pantethine: 300 mg three times per day, Magnesium: 200-400 mg three times per day, and Arginine: 1000 – 2000 mg three times per day.

Hawthorn berries are excellent for lowering blood pressure, cholesterol, and limiting

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angina attacks. By improving blood circulation and oxygen to the heart, hawthorn berries influence both the heart’s metabolic processes as well as the blood supply. Patients should consume hawthorn berries three times per day as either a tea or extract.

Before suggesting specific supplements to patients, it is essential to obtain a list of all medications they are currently taking to avoid any adverse reactions. According to Miller, Liebowitz, and Newby, the following herbs or supplements may interact with common cardiovascular drugs: feverfew, garlic, ginger, ginko biloba, dashen, ginseng, red ride yeast, gugulipid, vitamin E, CoQ10, Hawthorn (with digoxin), and St. John’s Wort (2004).

 Nutrition Strategies:

Patients should decrease or eliminate fried foods, sugar, animal proteins, saturated fats, and cholesterol and increase foods high in fiber, fish, and vegetables (especially onions and garlic).

Alternative Therapy:

EDTA Chelation therapy may help improve symptoms of angina by removing calcium found in arterial plaques, reducing inflammation and aiding in the reduction of cholesterol levels.

Lifestyle:

It is important to incorporate lifestyle practices that can help reduce stress and increase physical activity. Regular yoga practice can help reduce blood pressure, pulse, improve cholesterol levels, reduce blood glucose levels, and reduce body fat (Tyagi et al., 2014). In a study by Sinha, Jain, Tyagi, Gupta, and Mahajan (2018), after six months of meditation practice, patients had a significant decrease in both glycosylated hemoglobin levels and blood glucose levels.

Resources:

Banasik, J.L. & Copstead, L-E. C. (2019). Pathophysiology. (6th ed.). St. Louis: Elsevier.

Miller, K. L., Liebowitz, R. S., & Newby, L. K. (2004). Complementary and alternative medicine in cardiovascular disease: A review of biologically based approaches. The American Heart Journal, 147(3), 401-11. doi:http://dx.doi.org/10.1016/j.ahj.2003.10.021

Pizzorno, J.E. & Murray, M.T. (2013). Text book of natural medicine (4th ed.). St. Louis: Elsevier.

Sinha, S., Jain, A., Tyagi, S., Gupta, S., & Mahajan, A. (2018). Effect of 6 months of meditation on blood sugar, glycosylated hemoglobin, and insulin levels in patients of coronary artery disease. International Journal of Yoga, 11(2) doi:http://dx.doi.org/10.4103/ijoy.IJOY_30_17

Tyagi, Anupama,M.A., PhD.(c), & Cohen, Marc, MBBS, PhD, BMedSc,F.A.M.A.C., F.I.C.A. (2014). Yoga and hypertension: A systematic review. Alternative Therapies in Health and Medicine, 20(2), 32-59. Retrieved from https://search.proquest.com/docview/1503129427?accountid=158302

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