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Holistic Healing After a Heart Attack
By Barbra Williams Cosentino, RN, LCSW

It’s the size of a clenched fist and weighs somewhere between 7 and 15 oz, but the heart is an incredibly complex organ. According to the American Heart Association, it beats approximately 100,000 times and pumps about 2,000 gallons of blood per day, bringing oxygen and nutrients to the body’s organs and tissues and helping remove waste products from cells.
It’s an important job. And thanks to ongoing innovations in cardiac care, when blocked coronary arteries or other abnormalities lead to cardiovascular disease or a heart attack, medical professionals have a veritable toolbox of sophisticated high- tech interventions and drugs from which to choose.
But, since healing literally means “to make whole,” the body cannot be fully healed if the mind is still in a state of disease. Unfortunately, many cardiac treatment programs focus solely on medication regimens, diet, and exercise without adequately addressing the anxiety, depression, fear, and loneliness that can follow a serious cardiac event.
Untreated emotional stress stimulates the sympathetic nervous system, causing the body to go into “fight-or-flight” mode. In this state, the adrenal glands pump out stress hormones such as adrenaline, the heart rate and blood pressure are elevated, and the body’s musculoskeletal system tenses, all of which are potentially dangerous for people with cardiovascular disease.
An integrative approach to healing that fully addresses the mind-body-spirit components of health and wellness has a powerful ability to heal hearts physically and metaphorically. Active engagement between the patient and the healthcare practitioner can enhance the effectiveness of the healing process, but many techniques can be learned and used by the patient alone.
There is a wide array of mind-body therapies that have been shown to reduce stress by promoting what Herbert Benson, MD, a renowned cardiologist, associate professor of medicine at Harvard Medical School, and director emeritus of the Benson-Henry Institute for Mind Body Medicine, refers to as the relaxation response. When a patient is in a relaxed state, which is the opposite of the fight or flight mode, heart rate and blood pressure are decreased, the frequency of alpha (relaxed) brain waves is increased, oxygen consumption is reduced, and all of the physical manifestations of stress that affect the cardiovascular, hormonal, and immune systems return to normal functioning.
In his book, The Relaxation Response, Benson, a pioneer in the field of mind-body medicine, noted that this profound state of relaxation can be elicited by a variety of meditative techniques, including diaphragmatic breathing, repetitive prayer, progressive muscle relaxation, and yoga.

Additional Therapies 
Other holistic or mind-body therapies that can improve function and lead to optimal health and well-being in patients who’ve suffered a heart attack or other cardiac event include massage, interactive guided imagery, biofeedback, and nutritional therapy.

Hearts in Harmony, a health education initiative supported by the patient advocacy group Mended Hearts, in partnership with Daiichi Sankyo, Inc and Eli Lilly and Company, encourages survivors to find ways to care for their minds, as well as their bodies, pointing out that adopting healthy living practices can reduce the risk of future heart attacks.

Experts from Hearts in Harmony state that the use of music therapy, which elevates mood and reduces feelings of stress, can be an especially effective way to support physical and emotional healing after a heart attack or stent placement.

Numerous studies also support this claim. The November 2009 issue of Harvard Health Letter reported on a study conducted at Massachusetts General Hospital, where a research team found that cardiac patients on bed rest who listened to music for 30 minutes had lower blood pressure, slower heart rates, and less distress than those who didn’t listen to music. Another study done by researchers at Pavia University in Italy, published in the June 22, 2009, online edition of Circulation, showed that adults’ heart rate, blood pressure, and arterial blood flow changed in response to the tempo and volume of music being played.
Other forms of sound healing also promote profound states of relaxation. Chanting or the soft, slow repetition of mantras can synchronize brain waves to induce a calm, meditative state; toning, which “plays” with elongated vowel sounds, sighing, moaning, and other vibrational vocalizations, facilitates emotional release and encourages the flow of energy throughout the body. Some of these techniques are best learned with the help of a healing practitioner.
John M. Kennedy, MD, director of preventive cardiology and wellness at Marina Del Rey Hospital in California and the author of the newly released The 15 Minute Heart Cure: The Natural Way to Release Stress and Heal Your Heart in Just Minutes a Day, has drawn on aspects of sports psychology and transcendental meditation practice to develop what he calls the BREATHE Technique. “BREATHE is an acronym for a series of relaxation activities that incorporate guided imagery and conscious breathing techniques to connect the heart and brain and to allow us access into the conversation between the two organs,” explains Kennedy.  
He encourages cardiac patients to utilize imagery techniques to visualize their hearts as “strong and powerful, with all the parts—arteries, muscle, valves, and electrical system—working synergistically and efficiently.” One of his personal favorite imagery tools is his “path to relaxation and flow,” in which a patient envisions walking down a beautiful hiking path, becoming more and more serene along the way. “Because so much of interventional cardiology is about removing impediments to the healthy flow of blood and oxygen throughout the body, I find this to be a wonderful exercise on many different levels,” he says.
Guided imagery has the ability to reduce stress and anxiety, decrease blood pressure, enhance sleep, and contribute to an overall sense of well-being, he explains, adding that activities that elicit the relaxation response also increase heart rate variability, which is an important factor in improving cardiovascular health.
The ancient arts of yoga and tai chi are powerful ways of reducing stress and promoting relaxation. Tai chi, also known as tai chi chuan, combines simple, flowing movements with deep breathing and has been shown to provide many of the same cardiovascular benefits as moderate impact aerobics without added stress on the body’s joints, bones, and muscles. Regular practice can lead to reduced feelings of anger and hostility and to a calmer acceptance.
Drugs to lower cholesterol, stents to prop open diseased blood vessels, and medications to regulate the heart’s rhythm, lower blood pressure, and prevent blood clots are all important weapons in the battle against cardiac disability and premature death. But we must encourage our older adult patients to incorporate a range of physical, spiritual, and psychological interventions into their lives and to nourish themselves both physically and emotionally. Embracing some holistic healing methods will enable them to continue to work, love, and play, and to enjoy a satisfying and productive life in spite of whatever physical limitations may remain.

— Barbra Williams Cosentino, RN, LCSW, is a medical writer and psychotherapist in private practice in Forest Hills, N.Y.