Synergy of Ayurvedic and Modern Medicine for Improving Left Ventricular Ejection Fraction in Heart Failure Post Myocardial Infarction: A Case Report

Heart failure following a myocardial infarction presents a daunting challenge, with major implications for patient morbidity and mortality. The associated co-morbidities, such as diabetes and hypertension, complicate the treatment course. Managing such patients is challenging and is associated with numerous hurdles that call for an integrated approach for successful management. The present case of a 35-year-old male patient who had previously experienced a Myocardial Infarction (MI) and subsequently developed heart failure with reduced Left Ventricular Ejection Fraction (LVEF). He came to pursue Ayurvedic treatment. The patient was already taking allopathic drugs, which were continued and Ayurvedic interventions were provided alongside them. The Ayurvedic medications included an herbal decoction consisting of Terminalia arjuna (Arjuna), Withania somnifera (Ashwagandha), Terminalia chebula (Haritaki), Curcuma longa (Haridra) and Boerhavia diffusa (Punarnava), given as 40 mL decoction twice daily before meals. Prabhakar Vati (2 tablets of 250 mg each, twice daily before meals along with warm water), Arjunarishta (15 mL mixed with 20 mL of warm water twice daily after meals) and Sarak Vati (2 tablets of 500 mg each at bedtime along with warm water) were administered for 40 days. Further, external Ayurvedic therapeutic procedures were administered, including Sarvanga Snehana (therapeutic oleation of the whole body) with Bala oil (for 15 minutes in the morning), Sarvanga Bashpa Swedana (steam fomentation) with Dashamula Kwatha (for five minutes in the morning) and Hridaya Basti (therapeutic retention of oil over the cardiac region) with Bala oil (for 20 minutes in the morning) for 40 days. Matra Basti (enema with medicated oil) with Bala oil (60 mL/day immediately after lunch) was administered for 15 days. After the 40-day treatment regimen, 2D Echocardiography (2D Echo) reports showed a marked improvement in the ejection fraction from 30-35% to 45-50%. There was an improvement in other parameters such as the New York Heart Association (NYHA) classification (from Class III to Class II), the Fatigue Severity Scale (FSS) (score reduced from 56 to 28), the Modified Fatigue Impact Scale (MFIS) (score reduced from 64 to 25) and the pitting oedema grade (from Grade 3 to Grade 1). Thus, Ayurveda offers promising outcomes in enhancing ejection fraction in cases of heart failure following a myocardial infarction.