Patients with aortic valve stenosis who have symptoms may require surgical heart valve replacement.
Heart malfunction during aortic valve stenosis
The heart is a muscular pump with four chambers and four heart valves. The upper chambers, the right atrium and left atrium (atria — plural for atrium), are thin-walled filling chambers.
Blood flows from the right and left atria across the tricuspid and mitral valves into the lower chambers (right and left ventricles). The right and left ventricles have thick muscular walls for pumping blood across the pulmonic and aortic valves into the circulation.
Heart valves are thin leaflets of tissue which open and close at the proper time during each heartbeat cycle.
The main function of these heart valves is to prevent blood from flowing backwards.
Blood circulates through the arteries to provide oxygen and other nutrients to the body, and then returns with carbon dioxide waste through the veins to the right atrium; when the ventricles relax, blood from the right atrium passes through the tricuspid valve into the right ventricle.
When the ventricles contract, blood from the right ventricle is pumped through the pulmonic valve into the lungs to reload on oxygen and remove carbon dioxide.
The oxygenated blood then returns to the left atrium and passes through the mitral valve into the left ventricle.
Blood is pumped by the left ventricle across the aortic valve into the aorta and the arteries of the body.
The flow of blood to the arteries of the body is impaired when aortic stenosis exists. Ultimately, this can lead to heart failure. Aortic stenosis occurs three times more commonly in men than women.
Angina Symptoms and Causes
Angina is a symptom of another heart problem, most commonly, heart disease. Causes of angina include aortic stenosis, arrhythmias (abnormal heart rhythms), emphysema, and poisoning.
Aortic valve stenosis can be caused by congenital bicuspid aortic valve, scarred aortic valve of rheumatic fever, and wearing of aortic valve in the elderly.
Symptoms
The major symptoms of Aortic valve stenosis are:
- chest pain (angina),
- fainting (syncope), and
- shortness of breath (due to heart failure).
In a low percentage of the patients with Aortic valve stenosis, the first symptom is sudden death, usually during strenuous exertion.
The exact reason for sudden death is unknown. It may be due to heart rhythm abnormalities secondary to inadequate blood flow through the narrowed aortic valve into the coronary arteries of the heart. Insufficient oxygen to the inner lining of the heart muscle occurs due to the lack of blood flow to the coronary arteries, particularly during strenuous exercise. Lack of oxygen in the heart muscles causes chest pain and possibly abnormal heart rhythms.
Chest pain is the first symptom in one-third of patients and eventually occurs in one-half of patients with aortic stenosis. Chest pain in patients with aortic stenosis is the same as chest pain (angina) experienced by patients with coronary artery disease. In both of these conditions, pain is described as pressure below the breastbone brought on by exertion and relieved by rest. In patients with coronary artery disease, chest pain is due to inadequate blood supply to the heart muscles because of narrowed coronary arteries.
In patients with Aortic valve stenosis, chest pain often occurs without any underlying narrowing of the coronary arteries. The thickened heart muscle must pump against high pressure to push blood through the narrowed aortic valve. This increases heart muscle oxygen demand in excess of the supply delivered in the blood, causing chest pain (angina).
Fainting (syncope) related to Aortic valve stenosis is usually associated with exertion or excitement. These conditions cause relaxation of the body’s blood vessels (vasodilation), lowering blood pressure. In aortic stenosis, the heart is unable to increase output to compensate for the drop in blood pressure. Therefore, blood flow to the brain is decreased, causing fainting. Fainting can also occur when cardiac output is decreased by an irregular heartbeat (arrhythmia). Without effective treatment, the average life expectancy is less than 3 years after the onset of chest pain or syncope symptoms.
Shortness of breath from heart failure is the most ominous sign. It reflects the heart muscle’s failure to compensate for the extreme pressure load of aortic stenosis. Shortness of breath is caused by increased pressure in the blood vessels of the lung due to the increased pressure required to fill the left ventricle.
Initially, shortness of breath occurs only during activity. As the disease progresses, shortness of breath occurs at rest. Patients can find it difficult to lie flat without becoming short of breath (orthopnea). Without treatment, the average life expectancy after the onset of heart failure due to aortic stenosis is between 6 to 24 months.
What causes Aortic valve stenosis?
In adults, three conditions are known to cause Aortic valve stenosis.
- Progressive wear and tear of a bicuspid valve present since birth (congenital).
- Wear and tear of the aortic valve in the elderly.
- Scarring of the aortic valve due to rheumatic fever as a child or young adult.
Bicuspid Aortic valve stenosis is the most common cause of aortic stenosis in patients under age 65. Normal aortic valves have three thin leaflets called “cusps”. About 2% of people are born with aortic valves that have only two cusps (bicuspid valves). Although bicuspid valves usually do not impede blood flow when the patients are young, they do not open as widely as normal valves with three cusps. Therefore, blood flow across the bicuspid valves is more turbulent, causing increased wear and tear on the valve leaflets. Over time, excessive wear and tear leads to calcification, scarring, and reduced mobility of the valve leaflets. About 10% of bicuspid valves become significantly narrowed, resulting in the symptoms and heart problems of aortic stenosis.
The most common cause of Aortic valve stenosis in patients 65 years of age and over is called “senile calcific aortic stenosis.” With aging, protein collagen of the valve leaflets is destroyed, and calcium is deposited on the leaflets. Turbulence across the valve increases causing scarring, thickening, and stenosis of the valve once valve leaflet mobility is reduced by calcification.
Why this aging process progresses to cause significant aortic stenosis in some patients but not in others is unknown. The progressive disease-causing aortic calcification and stenosis has nothing to with healthy lifestyle choices, unlike the calcium that can deposit in the coronary artery to cause heart attack.
Rheumatic fever is a condition resulting from untreated infection by group A streptococcal bacteria. Damage to valve leaflets from rheumatic fever causes increased turbulence across the valve and more damage. The narrowing from rheumatic fever occurs from the fusion (melting together) of the edges (commissures) of the valve leaflets.
Rheumatic aortic stenosis usually occurs with some degree of aortic regurgitation. Under normal circumstances, the aortic valve closes to prevent blood in the aorta from flowing back into the left ventricle. In aortic regurgitation, the diseased valve allows leakage of blood back into the left ventricle as the ventricular muscles relax after pumping.
These patients also have some degree of rheumatic damage to the mitral valve.
Diagnosis
The carotid arteries carry blood from the aorta to the brain and are the closest arteries to the aortic valve that can be felt by the doctor examining the neck. Patients with significant aortic stenosis have a delayed upstroke and lower intensity of the carotid pulse which correlates with the severity of narrowing.
Aortic valve stenosis causes significant turbulence to blood flowing during contraction of the left ventricle resulting in a loud murmur. The loudness of the murmur does not, however, correlate with the severity of stenosis. Patients with mild stenosis can have loud murmurs, while patients with severe stenosis and heart failure may not pump enough blood to cause much of a murmur.
Electrocardiogram (ECG or EKG) 
An ECG or EKG is a recording of the heart’s electrical activity. Abnormal patterns on the EKG can reflect a thickened heart muscle and suggest the diagnosis of aortic stenosis. In rare instances, electrical conduction abnormality can also be seen.
Chest X-ray
A chest X-ray usually shows a normal heart shadow. The aorta above the aortic valve is often enlarged (dilated). If heart failure is present, fluid in the lung tissue and larger blood vessels in the upper lung regions are often seen. A careful inspection of the chest X-ray sometimes reveals calcification of the aortic valve.
Echocardiography
Echocardiography uses ultrasound waves to obtain images of the heart chambers, valves, and surrounding structures. There are several types of echocardiograms, for example, transthoracic echocardiogram, transesophageal echocardiogram (TEE), stress echocardiogram, dobutamine or adenosine/sestamibi stress echocardiogram, and intravascular ultrasound.
It is a useful non-invasive tool, which helps doctors diagnose aortic valve disease. An echocardiogram can show a thickened, calcified aortic valve which opens poorly. It can also show the size and functioning of the heart chambers. A technique called Doppler can be used to determine the pressure difference on either side of the aortic valve and to estimate the aortic valve area.
Cardiac catheterization
Cardiac catheterization is the gold standard in evaluating Aortic valve stenosis. Small hollow plastic tubes (catheters) are advanced under X-ray guidance to the aortic valve and into the left ventricle. Simultaneous pressures are measured on both sides of the aortic valve. The rate of blood flow across the aortic valve can also be measured using a special catheter. Using these data, the aortic valve area can be calculated.
A normal aortic valve area is 3 square centimeters. Symptoms usually occur when the aortic valve area narrows to less than 1 square centimeter. Critical aortic stenosis is present when the valve area is less than 0.7 square centimeters. In patients over 40 years of age, X-ray contrast agents can be injected into the coronary arteries (coronary angiography) during cardiac catheterization to evaluate the status of coronary arteries. If significant narrowing of the coronary arteries is found, coronary artery bypass graft surgery (CABG) can be performed during aortic valve replacement surgery.
Allopathic treatment for aortic valve stenosis 
Patients with mild Aortic valve stenosis do not require treatment or restriction of activity (I “Dr. Qaisar Ahmed MD” think that this is nonsense not to treat the disease in the early stages). Patients with moderate aortic stenosis (valve area 1.5 to 1.0 square centimeters) are advised to avoid strenuous activities such as weightlifting or sprinting.
Aortic valve stenosis can progress over a few years. Therefore, patients are usually examined annually and evaluated by echocardiography periodically to monitor disease progression. Since valve infection (endocarditis) is a serious complication of aortic stenosis, these patients are usually given antibiotics prior to any procedure in which bacteria may be introduced into the bloodstream.
When symptoms of chest pain, syncope, or shortness of breath appear, the prognosis for patients with Aortic valve stenosis without valve replacement surgery is poor. Medical therapy, such as the use of diuretics to reduce high lung pressures and remove lung fluid can provide only temporary relief of symptoms.
Patients with symptoms usually undergo cardiac catheterization. If severe Aortic valve stenosis is confirmed, aortic valve replacement is usually recommended. The overall mortality risk for aortic valve replacement surgery is about 5%. Advanced age should not be a reason for not recommending aortic valve replacement for aortic stenosis. Otherwise, healthy patients in their 80s with strong heart muscles often benefit dramatically from aortic valve replacement for critical aortic stenosis.
Replacement aortic valves processed from pigs (porcine) or cows (bovine) are called bio prostheses. Bio prostheses are less durable than mechanical prostheses but have the advantage of not needing life-long blood thinning (anticoagulation) medication to prevent blood clots from forming on the valve surfaces.
The average life expectancy of an aortic valve bio prostheses is 10 to 15 years. Bio prosthesis rapidly calcify, degenerate and narrow in young patients. Therefore, bio prosthesis are primarily used on older patients or in patients who cannot take blood thinners.
Mechanical prostheses have proven to be extremely durable and can be expected to last from 20 to 40 years. However, mechanical prosthetic valves all require lifelong anticoagulation with blood thinners to prevent clot formation on the valve surfaces. Otherwise, blood clots dislodged from these valves can travel to the brain and cause embolic stroke or embolic problems in other parts of the body.
The aortic valve area can be opened or enlarged with a balloon catheter (balloon valvuloplasty) which is introduced in much the same way as in cardiac catheterization. With balloon valvuloplasty, the aortic valve area typically increases slightly. Patients with critical Aortic valve stenosis can therefore experience temporary improvement with this procedure.
Unfortunately, most of these valves narrow over a 6-to-18-month period. Therefore, balloon valvuloplasty is useful as a short-term measure to temporarily relieve symptoms in patients who are not candidates for aortic valve replacement.
There is a new alternative available to high-risk surgical patients, referred to as transcutaneous aortic valve insertion (TAVI). In this procedure, a prosthetic aortic valve is inserted through the artery in the groin or via direct insertion into the heart, but without the need for open heart surgery. While the preliminary data is encouraging, it has only recently been released from investigational status, and its ultimate role in management is still being evaluated.
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Homeopathic treatment of aortic valve stenosis
There are many proven Homeopathic medicines (permanent treatment in – 30-90 days) for aortic valve stenosis, few of them are: 
Cactus Grandiflorus
Difficulty of breathing; attacks of suffocation with fainting. Chronic bronchitis, with rattling of mucus. Chest pricking pain, oppressed respiration (pneumonia). Periodical suffocation, with fainting, and sweat on face and loss of pulse. Hemoptysis, with convulsive cough. Sharp pains shooting from body to back and up into chest, with sensation of rush of blood to chest (rheumatism of diaphragm).
Cardiac pain with jerking body, frequently repeated. Pricking and stitches in the heart. Tachycardia, palpitation in small irregular beats (at times frequent, at others slow). Aortic valve stenosis. Pains in apex of heart, shooting down left arm to ends of fingers; feeble pulse; dyspnea. Endocardial murmurs; excessive impulse; increased precordial dullness; enlarged ventricle. Oedema of left hand only. Aneurysm. Atheromatous arteries.
Oedema lower extremities. General weakness and prostration of strength. Hemorrhages: from nose; lungs; rectum; bladder; stomach.
Constriction of neck of bladder. Irritation in urethra, as if pyuria. Urine passes by drops, micturition, urine of a straw color. urine with sediments of red sand. Hematuria; urination prevented by clots.
Constipation; stool hard and black. Diarrhea, watery, mucous, bilious (in forenoon). Copious hemorrhage with bowels. Rectal itching. Fluent hemorrhoids. Fissure and/or Fistula with violent tachycardia.
Crataegus Oxyacantha
Cardiac dropsy. Fatty degeneration. Aortic disease. Extreme dyspnea on least exertion, without much increase of pulse. Pain in region of heart and under left clavicle. Heart muscles seem flabby, worn out. Cough (cardiac cough). First cardiac sound weak. Pulse accelerated, irregular, feeble, intermittent. Valvular murmurs. Cutaneous chilliness, cyanosis; all these symptoms aggravated by exertion or excitement. Sustains heart in infectious diseases.
Excessive perspiration. Skin eruptions. Insomnia of aortic patients.
Glonoinum (Nitro-glycerine)
Tachycardia with heat in the face, accelerated pulse and pulsation of the carotid arteries, distinct pulsation over the whole body. In the heart sensation of fullness, heaviness, and heat, with labored beating of the heart. Pulse accelerated; rises and falls alternately; low and feeble in sunstroke. Severe stitches from the heart, extending into the back. Purring cardiac sounds when lying.
Polyuria, of pale color (albuminous); nocturnal polyuria and must pass large quantities of albuminous urine. Tubal nephritis, with headache, brought on by walking in the sun; numbness in arms and hands alternating with intense tingling.
Diarrhea with rumbling, sharp burning and discharges of flatus; diarrhea; copious, loose, blackish, lumpy.
Constipation and hemorrhoids which itched and pained. At an unaccustomed time, a hard and unusual stool; pinching in abdomen before and after stools.
Fainting with consciousness. Great weakness and prostration. Unconscious falling down (low brain blood circulation). Painless throbbing in the whole body. Pulsations, tingling, thrills, and a peculiar sensation of warmth through the body, extending from above downward. Fingers are spread apart and stretched out. Seeming plethora, rapid deviations in distributions of blood.
Yawning with headache, congestion of blood to the head. Insomnia but is difficult to waken. Pulse accelerated, irregular, intermitting, full and hard, small and rapid. Chill: after getting heated; alternates with sweat; with vomiting; head as if screwed up; intermittent fever. Perspiration principally in the face, forehead, chest and after sleeping. Perspiration relieves the nausea.
Naja Tripudians
Angina pectoris. Endocarditis. Asthma. Dysmenia. Aortic valve stenosis. Hay-fever. Headache. Cardiac diseases. spasmodic esophagus. Uneasiness and dull, heavy pain in chest – like hot iron rod. Lancinating pains feels better on deep inspiration. Asthmatic constriction of chest; followed by mucous expectoration. Cannot cough for the stabbing. Tenderness over sternum and in throat. Feeling of depression and uneasiness about heart.
Fluttering and palpitation of heart. Loud audible beating. Pulse slow and irregular in rhythm and force; weak and thread like, scarcely perceptible. Action only recognized by pushing hand up behind sternum, then felt only a faint thrill resembling the cardiac thrill felt in the same way on a newborn infant. Pulse rapid; and full; 120, some beats tolerably full and strong, afterwards 32, irregular in rhythm and force, some of the beats full and bounding. Cutting and aching in nape. Rheumatic pains in neck and back, between the shoulders.
Creeping, itching, and tingling sensation on the skin. Skin swelled, mottled, and of dark purple/cyanotic, livid color. Large pimples on inflamed base. Small white blisters on inflamed base, with much itching. Gangrene. Boil-like swelling. Painful chilblains on feet.
Body cold and collapsed. Extremities very cold; icy coldness. Burning heat in face. Free perspiration. Heat but refuses water; heat with prostration; with discomfort, dry lips, and tender, hot mouth. Head hot; and full of blood. Burning of ear. Flushes of heat in face at different times of day; flushes in face, hands, palms sweating, general sweating.
Digitalis 
Amaurosis. Angina pectoris. Aortic valve stenosis. Asthma. Bright’s disease. Cyanosis. Delirium tremens. Dropsy. Fever. Gonorrhea. Headache. Heart, affections of. Hydrocele. Hydrocephalus. Impotence. Jaundice. Lungs, congestion of. Memory lost. Meningitis. Noises in head. Paraphimosis. Prostate, enlarged. Ptyalism. Spermatorrhea. Toothache. Urinary disorders. Vision, disorders of.
Hoarseness (in the morning after a night sweat). Hollow, spasmodic cough, from roughness and scraping in the throat. Smarting in the chest on coughing. Cough worse at midnight and during the morning hours. The cough is caused by talking, walking, drinking anything cold, when bending the body forward. Troublesome choking sensation with cough.
Sensation of soreness in the chest. Respiration painfully restricted, especially at night, when lying down, or in the day, when walking, or seated. In the morning, suffocating constriction of the chest, forcing the patient to rise up in the bed. Asthmatic sufferings as from hydrothorax. Pressure on the chest from keeping the body bent. Tension in the chest, with necessity to breathe deeply. Contractive pain in the chest, when sitting with the body bent. Smarting in the chest. Sensation of weakness in the chest, proceeding from the stomach. Congestion in the chest. Shuddering at the mammae.
Tachycardia with palpitations that can be heard (with slow pulse), anguish, and contraction in the sternum. On rising up in bed pulse becomes much more frequent and irregular and intermittent, confusion of heart, sudden sensation as though heart stood still, with great anxiety and necessity for holding breath, after dinner; must keep perfectly still. Aortic valve stenosis.
Peculiar sensation as though heart standing still; single, violent, slow heartbeats, with sudden violent heat in occiput, and transient unconsciousness (the whole lasting only a moment). Shifting pains in heart. Oppression must breathe deeper. Heart’s action has lost its force; beats more frequent, intermittent, irregular. Palpitation easily excited on going up slight ascent. Heart seems to dilate slowly; palpitation at each movement of body; slight uneasiness at heart, cold sweats. Constant pain or anguish at heart, with palpitation accompanied by sinking sensation, face purple; fainting, believes he/she is dying; dizziness ringing in ears; sharp pain in left shoulder and left arm, tingling in arm and fingers; paroxysms come sometimes at night, with suffocation, wakes up in anguish; terrifying dreams.
Heart so weak that even sitting up in bed has caused fatal syncope. Attacks of angina brought on by any slight careless movement, especially of arms in an upward direction; inexpressible anxiety with fainting; for a moment heart seems to stand still, and then several rapid and violent pulsations occur, with sensation as if heart had torn itself loose and were swaying to and fro by a thin thread.
Rauwolfia
Rauwolfia or ‘”Choti Chandan or Sarpagandha”, alkaloids work by controlling nerve impulses along certain nerve pathways. As a result, they act on the heart and blood vessels to lower blood pressure.
Rauwolfia Q due to its sedative action helps reduce high blood pressure including insanity-produced irritation of the central nervous system and alleviates its associated symptoms such as irregular beats, increased emotional excitability, and mild depression, gives best results in aortic valve stenosis. Rauwolfia serpentina Q is also used as a laxative, diuretic, and antidote to snake venom and helps during delivery to stimulate the uterine contractions and promote the expulsion of the fetus. It also helps to be used in the treatment of a person with some combination of hallucinations, delusions, and extremely disordered thinking and behavior that impairs daily functioning.
Kalmia latifolia
Angina pectoris. Blindness. Bright’s disease. Dropsy. Dysmenorrhea. Gastralgia. Globus hystericus. Gout. Headache. Aortic valve stenosis. Endocarditis, Cardiac diseases. Herpes zoster; neuralgia after. Keratitis. Leucorrhea. Locomotor ataxia. Lumbago. Neuralgia. Paraplegia. Rheumatism. Rumination. Scleroderma. Scleritis. Somnambulism. Sun-headaches/Heat stroke. Syphilitic sore throat. Tinnitus. Tobacco eaters/smokers. Vertigo. Vomiting.
Difficult and oppressed breathing; throat feels swollen, nausea. Oppressed breathing with palpitation, anxiety; with pain (angina pectoris).
Feverish heat with great pain in chest; Pain in chest as from a sprain. Shooting through chest above heart into shoulder-blade to left hand. Rheumatism of muscles of thorax and back. Fluttering of heart. Tachycardia with anxiety, suppressed breathing; with faint feeling; with dyspnea, pain in limbs. Severe pain in cardiac region, slow, small pulse (hypertrophy, dilatation, aortic obstruction). Paroxysms of anguish about heart, dyspnea, febrile excitement; rheumatic endocarditis, with consequent hypertrophy and valvular disease. Wandering rheumatic pains in region of heart, Quickened but weak pulse. Pulse – slow, weak; arms feel weak; scarcely perceptible, limbs cold.
Muscles of neck sore to touch and on moving them. Constant pain in spine. Feeling of paralysis in sacrum. Aching in all joints. Rheumatic heart. Rheumatism often heart attacks, and generally goes from upper to lower parts; pains shift suddenly. Weariness in all muscles; shuns all exertion, can hardly go upstairs. Weary and giddy, with diarrhea. Weakness the only general symptom with neuralgia. Trembling, thrilling, strumming, with palpitation.
Sensation of rigidity of skin. Pricking sensation in skin, with moderate sweat. Dry skin. Erysipelatous inflamed eruption with oppressed breathing. Febrile excitement. General heat; with burning and pain in back and loins. Cold sweat.
Frequent micturition of large quantities of yellow urine. Albuminuria: with pains in lower limbs; with dropsy, casts, triple phosphates, sallow complexion, skin very dry.
Arsenicum Album
Shortness of breath, difficulty of respiration, choking, dyspnea, and attack of suffocation, endocarditis, sometimes with cold sweat, spasmodic constriction of the chest or of the larynx, anguish, great weakness, body cold, pain in the pit of the stomach, and paroxysm of cough.
The sufferings occur chiefly in the evening in bed, or at night, when lying down; also in windy weather, in the fresh and cold air, or in the heat of a room, or when warmly clothed, on being fatigued, on being angry, on walking, on moving, and even on laughing.
Respiration anxious, stertorous, and wheezing. Oppression of the chest on coughing, on walking, and ongoing upstairs. Constriction and compression of the chest, sometimes with great anxiety, inability to speak, and fainting fits. Tension and pressure in the chest. Stitches and pressing in the sternum. Shooting pains in the chest and in the sternum. Chilliness or coldness in the chest. Shivering, or great heat and burning in the chest. Heat, burning, itching in the chest. Yellowish spots on the chest.
Violent and insupportable throbbing of the heart, chiefly when lying on the back. Irregular beatings (bradycardia) sometimes with anguish and cramps. Palpitation and trembling weakness after stool; must lie down. Palpitation after suppressed herpes or foot-sweat. Angina pectoris. Hydropericardium. Fatty degeneration. Aortic valve stenosis.
Fever with great weakness, dropsical affections, pains in the regions of the liver and of the spleen. Frequent colliquative, or cold and viscid sweats; sweat at night, or in the evening on going to sleep, or in the morning on waking; partial sweat, chiefly on the face and legs. Perspiration cold, clammy, smelling sour or offensive.
Retention of urine. Frequent inclination, nocturnal polyuria with abundant emission. Incontinence of urine which escapes almost involuntarily, even at night, in bed. Difficult and painful emission of urine. Scanty urine, of a deep yellow color. Urine aqueous, greenish, brownish, or turbid, with mucus-like sediment. Sanguineous urine.
Aconitum Napellus 
Blindness. Chill. Convulsions. Deafness. Dyspnea. Ears noises (tinnitus). Hemicrania. Hydrophobia. Landry’s paralysis. Liver enlargement. Neuralgia. Esophagus spasms. General Spasms. Spleen enlargement. Tetanus. Tongue affections. Trismus. Vomiting.
Short breathing, chiefly during sleep, and on getting up. Breathing painful, anxious, and attended with groans, rapid and superficial, or full, noisy, and with the mouth open. Breathing slow during sleep. Breath hot. Breath fetid. Constriction and anxious oppression of the chest, with difficulty of breathing.
Asthma of Millar. Attack of suffocation, with anxiety. Sensation of heaviness and of compression at the chest. Painful pricking in the chest, chiefly when breathing, coughing, and moving (even the arms). Stitches through the chest and side, esp. when breathing and coughing. Pricking in the side, with a lachrymose and plaintive humor, soothed, in some degree, by lying on the back. Pleurisy and pneumonia, especially with great heat, much thirst, dry cough and great nervous excitability, only somewhat relieved when lying on the back. Itching in the chest. Pains as of a bruise in the sternum and in the sides. Sensation of anguish in the chest, which interrupts respiration.
Palpitation of the heart, with great anxiety, heat of body, chiefly in the face, and great weariness in the limbs. Shootings in the region of the heart when moving or going upstairs. Sensation of compression and blows in the region of the heart. Inflammation of the heart. Chronic diseases of the heart, with continuous pressure in the left side of the chest, oppressed breathing when moving fast and ascending steps, stitches in the region of the heart, congestions to the head; attacks of fainting and tingling in the fingers. Aortic valve stenosis. Fainting with tingling. Pulse full, strong, hard; slow, feeble; threadlike with anxiety; quick, hard, small.
Suppression of urine, with pressure in the bladder and pains in the loins. A frequent desire to discharge urine. Flow of urine, with sweat, diarrhea, and colic. Involuntary urination (relaxed neck of the bladder). Enuresis, with thirst. Urine scanty, burning, deep red, and with a sediment of a brick color (arising from taking cold, especially in children); suppression from cold. Bloody sediment in the urine. Scanty, red, hot. Heat and tenesmus in the neck of the bladder.
Adonis Vernalis
A heart medicine, after rheumatism or influenza, or Bright’s disease, where the muscles of the heart are in stage of fatty degeneration, regulating the pulse and increasing the power of contractions of heart, with increased urinary secretions. Aortic valve stenosis. Most valuable in cardiac dropsy. Low vitality, with weak heart and slow, weak pulse. Hydrothorax, ascites. Anasarca.
Head feels light; aches across front, from occiput around temples to eyes. Vertigo on rising, turning head quickly or lying down. Tinnitus. Scalp feels tight. Eyes dilated. Mitral and aortic regurgitation. Chronic aortitis, Fatty heart pericarditis. Rheumatic Endocarditis. Aortic valve stenosis. Precordial pain, palpitation, and dyspnea. Marked venous engorgement. Cardiac asthma. Fatty heart. Myocarditis, irregular cardiac action, constriction and vertigo. Pulse rapid, irregular.
Quebracho 
Asthma, Cardiac asthma. Aortic valve stenosis. Fever. Respiratory paralysis, slow heart rate. Paralysis of extremities. Dyspnea in phthisis and pleurisy. Cardiac asthma with livid face; and dyspnea with cyanosis.
1) Mitral incompetence and stenosis with severe nocturnal dyspnea. Aortic valve stenosis.
2) Fatty heart (Queb. had no influence on the oedema, which was removed by Dig.). Jos. P. Cobb (quoted A. H., xxvii. 74) records a case of heart affection of some duration in a man, 24. There was some enlargement, especially of right side, much dyspnea, and a slight mitral murmur.
Emphysema and severe attacks of asthma. Sputum heard, and “pearls” of rounded gelatinous masses were expectorated. Aspidospermine 3x gave more relief than any other remedy.
Terminalia Arjuna
Cardiac asthma and bronchodilator. Aortic valve stenosis. An astringent, demulcent, expectorant, cardiotonic, styptic, antidysentery, urinary astringent, and has shown to be useful in fracture, ulcers, leukorrhea, diabetes, anemia, cardiomyopathy, endocarditis and cirrhosis. This Homeopathic mother tincture can be used for improving cardiovascular health and it strengthens cardiac muscles and prevents any serious illness affecting it, anginal pain, hypertension, congestive heart failure, and dyslipidemia,
Helps in improving energy levels and reduces fatigue, reduces risk factors and has fewer side effects. Terminalia Arjuna is useful in both organic and functional diseases of the heart.
In fractures, pain all over the body owing to a fall and all sorts of ecchymosis.
Arjuna is also efficacious in spermatorrhea and gonorrhea.
Spigelia
Adenoids. Amaurosis. Angina pectoris. Aortic valve stenosis. Ciliary neuralgia. Cold. Constipation. Depression of spirits. Diaphragm, stitches in. Exophthalmic goiter. Eyes pains. Gastric catarrh. Glaucoma. Headache. Cardiac diseases, Endocarditis. Hernia, inguinal. Iritis. Jaw-joint, pain in. Neuralgia. Otalgia. Post-nasal catarrh. Prostatorrhea. Pterygium. Rectum cancer. Rheumatism. Scarlatina. Sigmoid flexure cancer. Stammering. Strabismus. Tinnitus. Tobacco habit. Toothache. Worms.
Catarrh, with hoarseness, continual discharge of mucus from nose, dry heat without thirst, prominent eyes, distressing headache, and disposition to weep. Nocturnal catarrh, with cough. Cough in open air, with pain in chest as from excoriation. Dry cough, violent and hollow, caused by irritation low down in trachea, with respiration obstructed, even to suffocation. Short, dry cough causing soreness of chest. Shortness of breath with anxiety and redness of cheeks and lips. Dyspnea when moving in bed; can only lie on right side or with the head very high. Danger of suffocation on least movement.
Contraction of chest, with anguish and obstructed respiration. Stitches in diaphragm with dyspnea. Cardiac regurgitation. Pressure, burning or incisive sensation pain. Sensation of trembling in thorax. Spasmodic sensation in chest, proceeding from pit of stomach and causing choking.
Sensation in heart as if squeezed with hand or as if crushed. Lancinations in region of heart. Stitches in heart sometimes synchronous with the pulse. Sensation of cardiac trembling. 
Heartbeat do not correspond with those of the pulse. Pulse weak, irregular, trembling. Visible pulsation of heart. Violent, oppressive action of heart extending to top of head. Tumultuous action of heart in acute rheumatism and other acute disorders.
Needle-like stitches in upper dorsal vertebrae and in right scapula. Sensation in l. scapula as though blood were dripping through a valve, a kind of bubbling, pain in parotid gland.
Skin pale, wrinkled. Painful sensibility. Painful glandular swellings. Red pimples, with pain, as from excoriation, when touched.
Heat in face and on hands, with chill in back. At night putrid perspiration with heat at same time. Clammy perspiration. Cold perspiration.
Urine, with whitish sediment. Polyuria with profuse emission, even at night. Sudden and involuntary dribbling of urine, with burning sensation in anterior part of urethra. Discharge of prostatic fluid from the urethra.
Veratrum viride
Amaurosis. Amenorrhea. Aortic valve stenosis. Apoplexy. Asthma. Bunions. Inflammation of caecum. Chilblains. Chorea. Congestion. Convulsions. Endocarditis. Diplopia. Diaphragmatic infections. Dysmenorrhea. Erysipelas. Headache, nervous; sick. Heart, affections of. Hiccough. Hyperpyrexia. Influenza. Malarial fever. Measles. Meningitis. Menses, suppressed. Myalgia. Esophagus spasm. Orchitis. Pneumonia. Proctalgia. Puerperal convulsions. Puerperal mania. Sleep dreamful. Spine, congestion. Spleen congested. Sunstroke. Typhoid fever. Uterus congestion.
Congestion of chest with rapid respiration, nausea, vomiting; dull burning in region of heart. Pneumonia and pleurisy: pulse hard, strong, quick, or slow and intermittent; lungs engorged; faint feeling in stomach; high fever, face flushed.
Palpitation and dyspnea. Violent palpitation of heart and faint feeling. Faintness and biliousness; when rising from lying; from sudden motion; lying quietly. Pulse: slow, soft and weak; irregular, intermittent; suddenly increases and gradually decreases below normal. Aching in neck and shoulder, almost impossible to hold head up.
Pallor with syncope. Tremor. Spasm with violent shrieks; opisthotonos; face dark blue; breath suspended; lasting two minutes and recurring after few minutes’ interval. Convulsions. Chorea, movements continuing in sleep. Hemorrhage from various organs.
Body cold but moist skin. Profuse diaphoresis and sense of utter prostration. Bathed in cold sweat. Cold, clammy sweat on forehead. Irritative fever with cerebral congestion. Streptococcus fever; rapid and violent alternations of temperature. Ephemeral fevers with nausea and retching. Cerebro-spinal fever. Typhoid. Yellow fever.
Amylenum Nitrosum
On inhaling this drug, it rapidly dilates all arterioles and capillaries, producing flushing of face, heat, and throbbing in the head: Superficial arterial hyperemia. Palpitation of the heart and similar conditions are readily cured by it, especially the flushing and other discomforts at climacteric. Hiccough and yawning. Often relieves temporarily epileptic convulsions. Seasickness. 
Anxiety, as if something might happen; must have fresh air. Surging of blood to head and face; sensation as if blood would start through skin, with heat and redness. Flushing, followed by sweat at climacteric. Ears hyperemic. Throbbing.
Dyspnea and asthmatic feelings. Aortic valve stenosis. Great oppression and fullness of chest; spasmodic, suffocative cough. Precordial anxiety. Tumultuous action of heart. Pain and constriction around heart. Fluttering at slightest excitement.
Sometimes followed by cold and clammy skin and profuse sweat. Throbbing throughout whole body. Abnormal sweat after influenza.
Extremities – constant stretching for hours. Veins of hands dilated; pulsations felt in tips of fingers.
Calcarea Carbonica
Raised blood coagulability. Is a definite stimulant to the periosteum. Palpitation at night and after eating. Aortic valve stenosis. Palpitation with feeling of coldness, with restless oppression of chest; after suppressed eruption. Pain as if sprained; can scarcely rise; from over lifting. Pain between shoulder-blades, impeding breathing. Rheumatism in lumbar region; weakness in small of back. Curvature of dorsal vertebrae. Nape of neck stiff and rigid. Renal colic. Swelling of joints, especially knee. Burning of soles of feet. Sweat of hands. Arthritic nodosities. Soles of feet raw. Feet feel cold and dead at night.
Aurum Metallicum
Alcohol’s effects. Amenorrhea. Angina pectoris. Asthma. Aortic valve stenosis. Depression. Haemorrhoids. Hemiopia. Hydrocele. Jaundice. Locomotor ataxy. Melancholy. Melanosis. Mercurial poisoning. Nasopharyngeal catarrh. Night terrors. Ozoena. Paralysis. Phthisis. Pining boys. Scrofula. Nodular tongue. Tumours. Uterus induration. Vertigo. Vision disordered.
Burning heat and cutting pain in right hypochondrium. Accumulation of mucus in the trachea and in the chest, which is expectorated with difficulty in the morning. Voice nasal. Cough from want of breath at night. Morning cough with tough yellow sputum.
Difficulty of respiration at night, and on walking in the open air, requiring deep inspirations. Paroxysms of suffocation with constrictive oppression of the chest, falling, loss of sense, and facial cyanosis. Pain as if there were a plug placed under the ribs. Continuous aching in left side of the chest. Incisive pain, and obtuse shootings, near the sternum. Great weight on chest; especially on sternum. Much congestion in the chest. Aortic valve stenosis. 
Anxious palpitation of the heart, from congestion to the chest. Bradycardia sometimes by fits, sometimes with anguish and oppression of the chest. Cardiac pain extending down left arm to fingers. Floundering heart. When walking, the heart seems to shake as if it were loose. Sensation as if the heart stood still. Palpitation compels him to stop.
Painful retention of urine, with urgent inclination, pressure on the bladder. Polyuria. Urine turbid like butter-milk, urine with thick mucus-like sediment.
Pulse small but accelerated. Febrile shiverings over the whole body, while in bed in the evening, followed neither by heat nor thirst. Body coldness with bluish colour of the nails (capillary blood circulation), nauseous taste with inclination to vomit. Heat of the face, with cold in upper and lower extremities. Copious general morning perspiration; mostly about genitals.
Baryta Carb
Dry, suffocative cough, especially in old people, full of mucus but lacking strength to expectorate, worse every change of weather. Larynx feels as if smoke were inhaled. Chronic aphonia. Stitches in chest; worse inspiration. Lungs feel full smoke.
Palpitation and distress in region of heart. Aneurysm. Aortic valve stenosis. Accelerates the heart’s action at first, blood pressure much increased, contraction of blood vessels. Palpitation when lying on left side, when thinking of it especially; pulse full and hard. Cardiac symptoms after suppressed foot-sweat.
Swollen glands in nape of occiput. Fatty tumors about neck. Bruised pain between scapulae. Stiffness in sacrum. Weakness of spine. Pain in axillary glands. Cold, clammy feet. Fetid foot-sweats. Numbness of limbs. Numb feeling from knees to scrotum; disappears when sitting down. Toes and soles sore; soles painful when walking. Pain in joints; burning pains in lower limbs.
Rhus Toxicodendron
Tickling behind upper sternum. Dry, teasing cough from midnight until morning, during a chill, or when putting hands out of bed. Haemoptysis from overexertion; blood bright red. Influenza, with aching in all bones. Hoarseness from overtraining voice. Oppression of the chest, cannot get breath with sticking pains. Bronchial coughs in old people, worse on awaking and with expectoration of small plugs of mucus. 
Cardiac hypertrophy from overexertion. Pulse quick, weak, irregular, intermittent, with numbness of left arm. Trembling and palpitation when sitting still. Aortic valve stenosis.
Pain between shoulders on swallowing. Pain and stiffness in small of back; better, motion, or lying on something hard; worse, while sitting. Stiffness of the nape of the neck.
Kalium Carbonicum
Cutting pain in chest; worse lying on right side. Hoarseness and loss of voice, dry, hard cough with stitching pains and dryness of pharynx. Bronchitis, sensitive chest. Expectoration scanty and tenacious, but increasing in morning and after eating; aggravated right lower chest and lying on painful side. Hydrothorax. Leaning forward relieves chest symptoms. Expectoration must be swallowed; cheesy taste; copious, offensive, lump. Coldness of chest. Wheezing. Cough with relaxed uvula. Tendency to tuberculosis; constant cold taking; better in warm climate.
Sensation as if heart were suspended. Aortic valve stenosis. Palpitation and burning in heart region. Weak, rapid pulse; intermits, due to digestive disturbance. Threatened heart failure. Stiffness and paralytic feeling in back. Burning in spine. Lumbago with sudden sharp pains extending up and down back and to thighs.
Lachesis
Upper part of windpipe very susceptible to touch. Sensation of suffocation and strangulation on lying down, particularly when anything is around throat; compels patient to spring from bed and rush for open window. Spasm of glottis; feels as if something ran from neck to larynx. Feels he must take a deep breath. Cramp-like distress in praecordial region. Cough; dry, suffocative fits, tickling. Little secretion and much sensitiveness; worse, pressure on larynx, after sleep, open air. Breathing almost stops on falling asleep. Larynx painful to touch. Sensation as of a plug which moves up and down, with a short cough.
Palpitation, with fainting spells, especially during climacteric. Constricted feeling causing palpitation, with anxiety. Cyanosis. Irregular beats. Aortic valve stenosis.
Strophanthus Hispidus
Strophanthus is a muscle poison; it increases the contractile power of all striped muscles. Acts on the heart; increasing the systole and diminishes the rapidity. Aortic valve stenosis.
Dyspnoea, especially on ascending. Lungs congested. edema of lungs. Bronchial and cardiac asthma. Pulse quickened. Heart’s action weak, rapid irregular, due to muscular debility; and insufficiency. Cardiac pain.
Apocynum Cannabinum
Short, dry cough. Respiratory short and unsatisfactory. Sighing. Oppression about epigastrium and chest. Aortic valve stenosis. Tricuspid regurgitation; rapid and feeble, irregular cardiac action, low arterial tension, pulsating jugulars, general cyanosis and general dropsy. 
Increases secretions of mucous and serous membranes and acts on cellular tissue, producing oedema and dropsy and on skin causing diaphoresis. Acute hydrocephalus. A diminished frequency of the pulse is a prime indication. This is one of our most efficient remedies, in dropsies, ascites, anasarca and hydrothorax, and urinary troubles, especially suppression and strangury. In the digestive complaints of Bright’s disease, with the nausea, vomiting, drowsiness, difficult breathing, it will be found of frequent service. The dropsy is characterized by great thirst and gastric irritability. Arrhythmia. Mitral and tricuspid regurgitation. Acute alcoholism. Relaxation of sphincters.
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Gastroenterologist, Specialist Homeopathic Medicines.
Senior research officer at Dnepropetrovsk state medical academy Ukraine.
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