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<p style="text-align:justify;">The term "hridaya" is derived from the Sanskrit language, and its etymology can be broken down to understand its meaning: The core of the word "Hridaya" comes from the Sanskrit word "Hṛd [हृद्]" which denotes the heart or the centre. ‘Hru’ means one which draws fluid or blood from the body forcibly, and ‘Da’ means to give. This term is fundamental to the concept, capturing the essence of the organ's centrality in both a physiological and metaphorical sense.</p>
<p style="text-align:justify;">The term "hridaya" is derived from the Sanskrit language, and its etymology can be broken down to understand its meaning: The core of the word "Hridaya" comes from the Sanskrit word "Hṛd [हृद्]" which denotes the heart or the centre. ‘Hru’ means one which draws fluid or blood from the body forcibly, and ‘Da’ means to give. This term is fundamental to the concept, capturing the essence of the organ's centrality in both a physiological and metaphorical sense.</p>
== Definition of hridaya ==
<p style="text-align:justify;">The term "Hridaya" carries multifaceted meanings within the Ayurvedic context. In its essence, hridaya signifies more than a physical organ; it is a dynamic force governing the body, mind, and senses. [Cha. Sa. Sutra Sthana.30/4] Critical analysis of Ayurvedic literature reveals that Ayurveda includes the heart and the brain under the umbrella term 'Hridaya.'</p>
== Structure of hridaya ==
<p style="text-align:justify;">Understanding the structure of the hridaya is pivotal in comprehending its diverse functions. From a physiological perspective, the hridaya is commonly associated with the heart, a muscular organ situated in the chest. The heart is like a lotus in an inverted position. It is open while awakening and contracted during sleep. [Su. Sa. Sutra Sthana 4/32]</p>
== Origin/ utpatti ==
<p style="text-align:justify;">The heart is formed from the sara[essence] of shonita and kapha [Su. Sa. Sutra sthana 4/31]. It is the supporter of the pranavaha dhamanis. Below the heart on the left side are the pleeha(spleen) and the phupphusa(lung), and on its right and below are the yakruta (liver) and kloma (pancreas). When this is covered by tamas (delusion,ignorance), all living beings sleep. [Su. Sa. Sutra sthana 4/31].</p>
=== Size: ===
The pramana of hrudya is two angula. [Cha. Sa.Vimana sthana 8/117]
== Importance of hridaya ==
<p style="text-align:justify;">The hridaya is a vital organ, intricately linked to the trimarams and dasha pranaayatana, encompassing the three doshas and ten pranas. All these factors govern physiological processes. Any harm to the hridaya is believed to result in severe diseases, complications, or even death. The ayurvedic texts highlight that the hridaya serves as more than a pump for blood circulation. It is depicted as the central regulator of prana, orchestrating its flow rhythmically. Moreover, the hridaya governs the body, mind, and senses, acting as the seat of intelligence and vitality.</p>
== Hridaya in different contexts ==
=== Hridaya as koshthanga and pratyanga ===
<p style="text-align:justify;">Hridaya is mentioned as one of the organs of koshthanga. According to Charak, fifteen koshthangas have been mentioned. These include nabhi [umbilicus], hridaya [heart], kloma [oesophagus], yakrit [liver], pliha [spleen], vrikka[kidney], basti [urinary bladder], purishadhara [colon], amashaya [stomach], pakvashaya [intestine], uttaraguda [rectum], adhara guda [anus], kshudrandra [small intestine], sthulantra [large intestine] and vapavahanam [omentum]. [Cha. Sa. Sharira Sthana 7/10] [A.Hr. Sharira Sthana 4/1,12] </p>
=== Pranayatana ====
<p style="text-align:justify;">Hridaya is one of the organs of pranayatanam. Pranayatanam is also called as jivitadhamam. "Ayatanam" means resting place, and "dhamam" means residence. These are the resorts of life. There are ten pranayatana or jivitadhama situated in our body. These are murdha [head], kantha [throat], hridaya [heart], nabhi [umbilicus], gudam [anus], basti [bladder], ojas, shukram [reproductive elements], shonitam [blood] and mansa [muscle]. Out of these, the first six organs are said to be "Marma”. [Cha. Sa. Sharira Sthana 7/9] </p>
=== Roga marga ===
<p style="text-align:justify;">There are three roga margas (pathways to diseases) shakha, marmasthisandhi and koshtha. Madhyama roga marga includes diseases involving marmas (vital organs i.e. basti (bladder), hrudya (heart), murdha (head) etc.) Hridaya is one of the madhyama roga marga.[ Cha. Sa. Sutra sthana 11/48] The disease of madhyama rogamarga will be krichhrasadhya.<ref name="ref2">Sengupta N, Sengupta B; Gangadhara commentary on Charaka Samhita Sutrasthana Tistraishaniya Adhyaya, 11/30; 3rd edition, Chaukhamba publishers, Varanasi; 2009.</ref></p>
=== As a site of different physiological entities ===
<p style="text-align:justify;">The heart is the seat of chetna (consciousness) [Su. Sa. Sharira Sthana 4/34], sadhaka pitta i.e. known to help in the achievement of the desired objects [Su. Sa. Sutra Sthana 21/10], vyana vayu[ash.hru. Su.12/6] i.e. responsible for causing circulation of rasa dhatu all over the body simultaneously and continuously; and para oja as well, [Sh. Sa. Pu. 5/49]. Hridaya is said to be chaitanaya sangraha by acharya charaka. [Cha. Sa. Sutra sthana 30/7] In hridaya, are situated the ten dhamani (ten great vessels arising from the heart), prana, apana, manas (mind), buddhi (intellect), chetna (life) mahabhutas (five fundamental elements) just like spokes of the axle in the centre of a wheel.[Cha. Sa. Siddhi Sthana 9/4] Shadanga (six divisions of the body, i.e. four limbs, head, and torso), consciousness, sensory organs, five objects of sensory perceptions and the soul, mind and objects of the mind are all located in the heart (i.e. are dependent on the functioning of the heart).[Cha. Sa. Sutra Sthana 30/4]</p>
=== As one among the three vital organs ====
<p style="text-align:justify;">Basti [urinary bladder and urinary system], hridaya [heart and cardiovascular system] and shira [head & brain] are three vital organs (trimarma). [ Cha. Sa. Chikitsa Sthana 26/3]</p>
=== As a matruja bhava ===
<p style="text-align:justify;">Matruja means maternal. bhava means existence or innate property. The mridu [soft] parts like mamsa [muscle], shonita [blood], medas [fat], majja [bone-marrow], hridaya [heart], nabhi [umbilicus], yakrit [liver], pliha [spleen], antra [intestine], guda [anus] etc. are matruja bhava [origin of maternal innate property]. [Cha. Sa. Sharira Sthana 3/6]</p>
=== As srotas mula ===
<p style="text-align:justify;">The pranavaha srotas and rasa vaha srotas have their origin in hridaya. [Cha. Sa. Vimana Sthana 5/8]</p>
== Embryology ==
<p style="text-align:justify;">Acharya Charaka mentioned Kankayan’s view that hridaya is the first foetal organ to develop. [Cha. Sa. Sharira Sthana 6/21] Acharya Sushruta quoted Kartavirya's view that hridaya develops prior to other organs of the embryo itself being the site of buddhi [mental faculty] and manas [mind]. [Su. Sa. Sharira Sthana 3/32] Acharya Charak considered that the fetal heart starts pulsating in the third month. While Sushruta considered that the fetal heart starts functioning from the fourth month onwards [Su. Sa. Sharira Sthana 3/4]</p>
== Diversities in hridya dravyas ==
<p style="text-align:justify;">The term "hridya" is used in diverse contexts. The concept of "hridya mahakashaya," drugs that evoke pleasure and are considered suitable for the body. [Cha. Sa. Sutra Sthana 4/10] These substances, ranging from food articles to fragrances, act as stimuli that impart pleasurable sensations and are identified as hridya dravyas in classical Ayurvedic texts. While portraying the concept of hridya, it is essential to consider the motor, sensory, and psychological components. Any stimuli that impart a sense of pleasure to the respective sense organ and, consequently, to the hridaya are regarded as hridaya. This holistic approach recognizes the interconnectedness of physical and mental well-being.</p>
== General causative factors of diseases of heart ==
<p style="text-align:justify;">Hrudroga is caused by the following factors:<br/>
Excessive exercise, excessive use of articles having tikshna guna, administration of purgation and emetic therapies and enema in excess; excessive worry, fear, and stress, improper treatment of disease; emesis, ama, and suppression of natural urges; emaciation and trauma. [Cha. Sa.Chikitsa Sthana 26/77]</p>
=== Classification of diseases in heart ===
Heart-related diseases are broadly classified into five types: Vatika, paittika, kaphaja, sannipatika, and krimija [Cha. Sa. Sutra Sthana 17/6].
=== Other diseases and conditions with clinical features pertaining to heart ===
<ol style="text-align:justify;"><li>Vaataj Murchha–(syncope): Cardiac pain [Cha. Sa. Sutra Sthana 24/36] </li>
<li>Baddha guda udara (ascites due to obstruction)- Cardiac pain [Cha. Sa.Chikitsa Sthana 13/41]</li>
<li>Rasa kshaya (depletion of rasa dhatu)- Palpitation on little exertion - [Cha. Sa. Sutra Sthana 17/64] </li>
<li>Vaataj jwara (vata dominant jwara) - Stiffness in precordial or cardiac region [Cha. Sa.Nidana Sthana 1/21]</li>
<li>Aam jwara (jwara due to ama dominance)- Feeling of fullness of the heart [Cha. Sa.Chikitsa Sthana 3/133]</li>
<li>Purvarupa (premonitory sign of shwasa roga (respiratory disorders) [Cha. Sa.Chikitsa Sthana 17/20]</li>
<li>Kaphaja grahani – Feels as if cardiac region or heart is distended [Cha. Sa.Chikitsa Sthana 15/69]</li>
<li>Pandu (premonitory symptom of anemia)- Palpitation of heart [Cha. Sa.Chikitsa Sthana 23/43]</li>
<li>Kshayaja kasa (cough due to depletion) - Feels as if heart is displaced from its site due to coughing. [Cha. Sa.Chikitsa Sthana 18/26]</li>
<li>Madaatyaya (excess alcoholism) – Feeling of discomfort in cardiac region [Cha. Sa. Chikitsa Sthana 24/101]</li>
<li>Excessive consumption of amla rasa results in burning sensation in cardiac region - [Cha. Sa. Sutra Sthana 26/43], [Su. Sa. Sutra Sthana 42/10]</li></ol>
== Diagnostic tools and investigations ==
The following investigations can be done for the diagnosis of different diseases of heart region: <ref name="ref3">Munjal Y.P. API textbook of medicine 9th edition. The Association of Physicians of India 2012</ref>
# Chest X-ray
# Electrocardiogram (ECG or EKG).
# Holter monitoring.
# Echocardiogram.
# Exercise tests or stress tests.
# Cardiac catheterization.
# Cardiac MRI
# CT Angiogram
# TROP T
== Preventive measures ==
<p style="text-align:justify;">To protect heart, great vessels and ojas one has to avoid causes of mental suffering especially. Diet, drugs/medicines, and behaviour that are beneficial for the heart, for the formation of ojas and for keeping the vessels clear should be adopted, along with the pursuit of mental peace and wisdom. [Cha. Sa. Sutra Sthana 30/13]</p>
== Contemporary approach ==
=== Anatomical aspects in contemporary science: ===
<p style="text-align:justify;">The heart is a muscular organ in the centre of the chest behind the sternum. It consists of four chambers: the two upper chambers are called the right and left atria, and the two lower chambers are called the right and left ventricles. The right atrium and ventricle are often called the right heart, and the left atrium and left ventricle functionally form the left heart.</p>
[[File:Diagram of the human heart.jpg|thumb]]
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