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PrefaceAs a practicing cardiologist for five decades atAhmedabad, a thickly populated metropolis (five million) of Gujarat State, India, I feel happy to observethat large majority of coronary heart patients can leada useful life after recovering from heart attack. Mostof them can do without expensive interventions likeangioplasty or bypass surgery. Medical managementalong with lifestyle changes is enough to attain thisobjective. Only a few would benefit substantially byintervention.My teacher in UK gave me an excellent advicewhile congratulating me on my success on passing theMRCP examination with cardiology as a special subject. He said, "Doctor, I would like you to rememberthat, when a patient of heart attack seeks your advice,a person who has survived the heart attack is notgoing to die. With that confidence in your approach,you will be able to give maximum benefit of yourtreatment to your patient. You are well equipped withthe knowledge and you will continue to sharpen itwith your experience." This golden advice has proved agreat boon in my professional career.This advice confirms the first of the three tenets ofTibetan medicine enunciated by Dalai Lama toHarvard Professor Dr. Benson John who went toDharmashala to study the benefits of meditation.Tenet 1: Doctor's faith in himself that he is going tocure the patient. Tenet 2: Patient's faith in the doctorthat he is going to cure him. Tenet 3: The doctor'sKARMA---his skill and its application with love.For the last two decades since 2, October, 1991, wehave added a program of India's age-old philosophy ofYogic practice of Shavasana and Meditation to mainxv

stream medical management. This has contributed toprevention and rehabilitation of heart patients, resulting in successful total management. It diminishes thefear of the disease and empowers the patient to makelifestyle changes without a feeling of deprivation. Thisway the program not only aims to heal the coronarydisease but also heals the individual as a whole. Hencethe program came to be known as Universal HealingProgram (UHP). Moreover, the practice of UniversalHealing Program has the potential to ignite the spiritual strength of the humankind to live a healthy longlife overflowing with peace, happiness and love.My faith in combining Spirituality with Science hasbeen strengthened by Bruce H. Lipton, Ph.D; an internationally recognized leader in bridging science andspirit and a key voice in new biology. In his book “TheBiology of Belief”, he observes, “The fact that scientific principles led me, a nonseeker, to spiritual insightis appropriate because the latest discoveries in physicsand cell research are forging new links between theworlds of Science and Spirit. These realms were splitapart in the days of Descartes centuries ago. However,I truly believe that only when Spirit and Science areunited will we be afforded the means to create a betterworld."I sincerely hope that this book will serve to fulfillour commitment to dispel the fear of the disease andmake its management, including prevention and rehabilitation, efficient and affordable.Dr. Ramesh I. KapadiaMRCP (Cardiology) FRCP (Edin.)xvi

ContentsPart - I Coronary Heart Disease (CHD)1.Understanding Coronary Heart Disease11.1A Global Problem - 11.2Reflections on Coronary Heart Disease - 21.3Causes of Coronary Heart Disease - 51.4Inbuilt Tool - 71.5Chronic Angina and Ejection Fraction - 81.6New Thinking - 81.7Is Intervention Necessary? - 101.8Some Important Aspects of CHD - 111.9Yogic Discipline - A Powerful Tool - 122.Chronic Angina142.1What is Angina? - 142.2Chronic Angina - 152.3Understanding Your Angina - 162.4An Anginal Episode is not aHeart Attack - 172.5Unstable Angina - 172.6Management of Angina -182.7Successful Approach to Stop Smoking - 193.Prevention of Heart Attack233.1Understanding a Heart Attack - 233.2Key factors of Prevention - 253.3Plaque and Plaque Rupture - 273.4Formation of Plaque - 283.5Preventive Measures - 293.6After Angioplasty or Bypass Surgery - 31xviiH.H.-2

4.Heart Disease: A New Direction324.1Fear of Death - 324.2Allopathy and Alternative Therapies - 334.3Present Scenario in the Health Sector - 344.4Unique Program for CHD - 364.5New Direction - 374.6Experiences from Visit Abroad - 40Part - II Non-physical Causes ofCoronary Heart Disease5.Non-physical Causes5.1Isolation - 435.2Hostility - 465.3Test your Hostility Level - 495.4Cynicism - 505.5Ego - 505.6Remedy - 516.Stress and Stress Management546.1Change and Stress - 546.2Job Stress - 556.3Family Stress - 566.4Greed - 566.5Money Function Curve - 566.6The Effect of Stress on Performance - 586.7Stress Management: Yoga - 586.8Lifestyle Changes with theHelp of Yoga - 606.9Heart Rate Variability (HRV) - 616.10 Heart Resonance Imaging (HRI) - 617.Healing Process7.1Healing System - 637.2Further Note on Healing - 647.3Doctor's Role -65xviii4363

7.47.57.68.Conditions for Successful Treatment - 66Charak and Hippocrates - 68Abdominal Brain - 69In-depth Stress Management andHealing718.1Abdominal Breathing - 718.2Deep Breathing - 738.3Biofeedback - 748.4Shavasana - Ancient Art of Relaxation - 768.5Meditation - 778.6Visualization - 808.7Diet and Yoga - 818.8Walking - 81Part - III Science and Spirituality9.Creation of Health839.1Introduction - 839.2Biomedical Model - 879.3The Inner World of an Individual - 899.4Space, Time and Death - 919.5Connectedness - 929.6Consciousness - 949.7Universal Mind - 979.8Harmony - 979.9Law of Attraction - 989.10 Serendipity (Accidental Discovery) - 999.11 A Confluence of Physical andSpiritual - 1019.12 Coming of New Age - 10210. Shavasana: Key to Health and Bliss10.1 Shavasana - 10310.2 Science of Shavasana - 10410.3 Stretching and Relaxation - 107xix103

10.410.5Technique of Shavasana - 120Quick Shavasana - 12011. Science of Meditation12211.1 Essence of Meditation - 12211.2 Present Moment - 12211.3 Connectedness and Healing - 12511.4 Science, Spirituality and Meditation - 12611.5 Why Meditation? - 12811.6 What is Meditation? - 12911.7 Science of Meditation - 12911.8 Benefits of Meditation - 13011.9 Preparing for Meditation - 13111.10 Technique of Meditation - 13211.11 When is Meditation successful? - 13311.12 Why some find Meditation difficult? - 13311.13 One- Minute Meditation - 13411.14 Visualization - 13611.15 Auto-Suggestion - 13712. Universal Healing Program13812.1 Program for Coronary Healing - 13812.2 Universal Healing Program - 14012.3 Exit Evaluation - 14512.4 Guidelines to Participants - 14712.5 Group Discussion andSharing of Feelings - 14912.6 Rehabilitation after Myocardial Infarction(Heart Attack) - 15012.7 Code of Conduct - 15412.8 UHP and Education - 155Part - IV Wealth of Food and Health of Heart13. Balanced Diet13.1 Diet and Life Style - 157xx157

13Dietetic Regulations - 158Carbohydrates - 161Proteins - 162Fat - 163Fibre - 163Salt - 164Free Radicals - 164Raw Foods - 165Ideal Diet - 165Dieting - 167Small Frequent Meals - 168Eating With Awareness - 16814. Obesity16914.1 Defining Obesity - 16914.2 Factors Contributing to Obesity - 17014.3 Metabolism of Fat - 17114.4 Sugar - 17114.5 How to increase Fiber in Your Diet - 17214.6 Salt - 17414.7 Functions of Insulin - 17414.8 Development during Evolution - 17414.9 Isolation - 17514.10 Exercise - 17514.11 Correct Way to Eat - 17614.12 Taste - 17614.13 Meditation - 17714.14 Self-imposed Restraint - 17714.15 New Scientific Approach - 177Part - V Questions and Answers15. Frequently Asked Questionsxxi179

AppendicesI.Message from Sri Swami Satchidananda - 195Message from Larry Dossey, M.D - 196, 198Message from H. John Taylor - 200Message from Dr. M. R. Girinath - 201Message from Dr. B. M. Hegde - 202Preface to Primer of Universal Healing - 204II.On Life207III. Lessons from Geese209IV. An Opportunity to Think211V212Healthy LongevityGlossary220Subject Index221Reviews by Dr. Larry Dossey226List of Books228Centres of Universal Healing Program230Information about Program232xxii

Heal Your HeartHeart Disease, Prevention and Total Healingxxiii

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Everything in the world can be used and abused. Thisapplies to the body also. We abuse it when we use itfor selfish purposes, for self-indulgence or in order toharm another. It is put to its right use if we exerciseself-restraint and dedicate ourselves to the service ofthe whole-world. The human soul is a part of theUniversal Spirit or God. When all our activity isdirected towards the realization of this link, the bodybecomes a temple worthy for the Spirit to live in.Dt. 30-8-’42(‘Key to Health’)- Mahatma Gandhi1

Light Exercises2

Shavasana3

Meditation4

Group discussion in Universal Healing Program5

Dr. Ramesh Kapadia with Dr. Dean Ornish atSan Fransisco, U.S.A.6

Anniversary of Universal Healing Program. From left to right : Dr. Ramesh Kapadia,Swami Manuvaryaji, Mrs. Mrunalini Sarabhai, Mr Narayan Desai, Mr. Yashvant Shukla7

Anniversary of Universal Healing Program. From left to right : Mr. U. N. Mehta,Dr. P. C. Vaidya, Swami Manuvaryaji, Dr. Ramesh Kapadia, Mr. Yashvant Shukla8

Dr, Ramesh Kapadia with Swami Satchidanandaji of U.S.A.during Swamiji’s visit to Ahmedabad in December 19989

Acharya Mahaprajna unveiling the book on Shavasana in Hindi authored byDr. Ramesh Kapadia10

National Seminar organized at Gujarat Vidyapith on 1-10-2005. From left to right :Dr. Sudhir V. Shah, Dr. Solomon Victor, Dr. Ramesh Kapadia, Dr. B. M. Hegde,Dr. Richard Smith (U.K.) and Dr. Silva Murty11

Dr. Ramakanta Panda of Asian Heart Institute, Mumbai, unveils the book : Hridayrog :Sarvangi Abhigam written by Dr. Ramesh Kapadia in Gujarati on 2nd October, 2010 atGujarat Vidyapith. Left to right : Mr. Jitendra Desai, Managing Trustee, Navajivan Trust,Dr.Ramesh Kapadia, Dr.Ramakanta Panda and Dr.Sudarshan Iyengar, V.C., Gujarat Vidyapith.12

Part – ICoronary Heart Disease1. UnderstandingCoronary Heart Disease1.1 A Global ProblemThe heart disease is now a global problem and anumber one killer in the prime of life, results from thenarrowing of the coronary arteries due to deposition ofa fat-like material in the walls of the coronary arteries. Coronary arteries supply oxygen and nutrition tothe heart muscles. Narrowing of these arteries leads tolack of blood circulation in these arteries, leading topoor supply of oxygen and nutrition to heart muscle.This results in heart disease known as Coronary HeartDisease.Coronary heart disease is the single greatest causeof death in the Western world. Its incidence even inthe developing countries is growing at an alarmingrate. This incidence is attributed to sedentary habits,rich fatty diet, high blood pressure, diabetes, smoking,excess of alcohol and increased serum cholesterol.However, it has been observed that in more than 50%of the patients of coronary heart disease, the said oftrepeated factors do not operate. Something else is happening in these individuals, who prematurely becomethe victims of coronary heart disease without any ofthe known risk factors. On the other hand, it is observed that the mere control of risk factors does notalways affect the onward march of the progress ofcoronary heart disease. The recent experiment of1

2HEAL YOUR HEARTDr. Dean Ornish clearly shows that when the risk factors are controlled along with the in-depth stress management by the progressive deep relaxation, meditation, visualization, group discussion and the sharing offeelings, the results are very encouraging. Therefore acomprehensive program is necessary to forestall theravages of this disease.With the passing of time, understanding of coronaryatherosclerotic disease is no longer viewed as a staticprocess of advancing atherosclerosis. It is rather adynamic process where an emotional burst, smoking orother unknown factors cause ulceration in the wall ofthe artery (plaque rupture) resulting in sudden spasmin an atherosclerotic coronary artery and clumping ofplatelets with complete obstruction. Eighteenth centuryBritish surgeon John Hunter, who suffered from angina for forty years had observed, “My life is in thehands of a hooligan who chooses to excite me.” Dr.Hunter dropped dead soon after an intense debate atthe hospital board meeting, emphasizing the effect ofintense emotion on heart.Coronary heart disease remains an enigma. Exactetiology is not known. Tell-tale predisposing factors areheredity, hypertension, diabetes mellitus, high serumcholesterol with decreased concentration of HDL andtobacco smoking. Medical treatment is aimed at reducing the need of oxygen by the myocardium, preventionof spasm and clot formation in atherosclerotic coronaryarteries and surgical treatment (angioplasty or CABG)to restore the blood supply to the myocardium.1.2 Reflections on Coronary Heart DiseaseThe sudden death which occurs in Coronary HeartDisease has spread its mantle of fear over the wholecomplex problem of Coronary Heart Disease. However,it needs emphasis that a large number of Coronary

HEART DISEASE, PREVENTION AND TOTAL HEALING3Heart Disease patients even after the attack live ameaningful life for a long time. Simple linear mathematical relationships govern most of our thinking inmedicine. The dynamic human body does not followthese linear relationships, and doctors tend to predictthe unpredictable!The narrowing of the coronary arteries per se doesnot inevitably result in heart attack. The narrowingof the coronary arteries gradually progresses to acomplete block with the passage of time. However,occluded vessel does not pose the risk of a heart attackand its complications or even of a long term detrimental effect on heart function. The complete occlusionresulting in heart attack is almost always the result ofa blood clot causing obstruction of a moderately diseased vessel. In the absence of a heart attack, thenarrowed coronary artery typically does not alter overall left ventricular function despite evidence of theexercise-induced signs and symptoms of myocardialischaemia. It has been shown in some brilliant scientific studies that brief periods of ischaemia ( withoutsymptoms, termed silent ischaemia or stable anginainduced with exercise ) trigger adaptive changes in theheart, protecting it from future major failure of bloodsupply by ischaemic pre-conditioning or by promotingcollateral circulation. In this way such ischaemia mayeven prove beneficial to the heart.Coronary AngioplastyDiagnosis of coronary heart disease can be madeanatomically by studying the coronary arteriesinvasively with angiography, intravascular ultrasoundor non-invasively by stress testing using ECG,echocardiography or nuclear imaging. In any studycoronary revascularization using angioplasty orbypass surgery has not shown advantage in sav-

4HEAL YOUR HEARTing life when used in patients with stable angina. Angioplasty is shown to save life only inunstable patients or patients actually havingheart attack. On the contrary, the randomizedtrials have demonstrated that nitrates, aspirin,low fat vegetarian diet, beta-blockers, calciumblockers and angiotensin converting enzyme(ACE) inhibitors can save lives in patients withstable coronary heart disease. Current consensusis that angiography should be reserved forpatients where surgery or angioplasty is considered necessary. If angiography is done beforethat decision, just to "look", there is a risk ofthe patient being scared that he is sitting on a'volcano' which may kill him at any time. Thismay not be true.Bypass SurgeryFor a large number of patients undergoingbypass surgery there is no evidence that it improves their survival compared to those managed by medical means. Bypass surgery only improves survival in patients with the left main arterydisease or three vessel disease with impaired left ventricular function but does not offer survival benefitwhen the left ventricular function is good. Patientswith stable angina have very low annual mortality ofapproximately 1%, which is not significantly higherthan that of the general population. When the plaquegrows in the wall of the coronary artery, coronaryarteries are capable of remodeling themselves and enlarging at the site of obstruction. This reminds us ofour father of medicine, Hippocrates's observation thatthe body has inherent capacity to heal itself.In the patients who run the risk of sudden death asa result of the coronary heart disease, bypass surgery

HEART DISEASE, PREVENTION AND TOTAL HEALING5by and large does not afford any protection. Even theusual claim of better quality of life after the bypassneeds appraisal as new thoughts on the quality of lifedemand more critical appraisal of how it is measured.After angioplasty the restenosis rate may be as high as10-30% which is due to the increased cellular and fibrous growth (fibrocellular intimal hyperplasia) forwhich there is no easy solution in larization is intractable (not responding tomedical therapy) lifestyle limiting chest pain, acuteheart attack and poor left ventricular function withthree vessel disease. The coronary bypass surgery is aboon to these very ill patients. We should encouragerevascularization based on the patient's symptoms anddisabilities rather than on angiograms with so calledcritical narrowing of coronary arteries.All too frequently requested angiograms and advicefor angioplasty and bypass surgery by the wellintentioned highly qualified doctors is due to a different perception of the disease and its probable outcomein a particular patient. The so called "oculostenoticreflex", a tendency to believe that all occlusion need tobe opened, indeed is a problem and need rethinking inthis field.1.3 Causes of Coronary Heart DiseaseHeart has been considered the seat of emotions fromthe days of yore. No wonder, coronary artery diseasewhich results in coronary heart disease is now considered to be the ailment caused by the weakening ofspiritual qualities also. As the material progressabounds with the neglect of spiritual qualities, theincidence of the disease increases. This was the cornerstone of philosophy of Ayurved in causation of disease.The pioneering work of Dr. Dean Ornish and many

6HEAL YOUR HEARTothers including our experience with the UniversalHealing Program has clearly shown that in the ultimate analysis, the development of spiritual strengthchecks the progress of the disease at its roots. Theseobservations are made with full regard for the physicalaspects of the disease and its effective treatment bythe physical measures - medicines and surgery whenrequired.The qualities of the spirit have been defined in allthe scriptures of the world. However, the impact ofspiritual qualities on the physical plane of the bodyand the mind has lately become quite clear in all biological sciences.A patient of coronary heart disease (CHD) may havea strong family history, may be overweight, sedentaryin habits, a heavy smoker or may be drinking alcoholin excess. He may have an abnormal lipid profile (highserum cholesterol, low HDL, high LDL) and may besuffering from diabetes and hypertension. He may beoverstressed with a lack of social support and feelingisolated.Efforts were directed to deal with all these aspectsduring last fifty years, with measures like change infood habits, cessation of smoking, redu

"Heal Your Heart" is an excellent work on holistic approach for preventing heart disease, the leading killer of mankind at present. With his vast experi-ence in his technique of Univer-sal Healing Program he has em-phasized that the best way to control heart disease is to com-bine our an