Yoga asanas and Pranayam could be sometimes restricted in heart disease

Mostly we also know yoga asanas which are good for heart. Unfortunately, Yoga is not the "cure all" and it has its limitations too. The following is a question that cardiologists are being asked more and more commonly nowadays. This important information should be known to all those heart patients who practice yoga.

Q1: I have been diagnosed with heart disease. Which are the yoga asanas I should avoid?

You should avoid asanas that make your heart work too much.
1. Chakrasana (Wheel pose): This position is a backbend and requires a lot of strength and a proper breathing pattern. It puts pressure on your heart to pump blood faster and so it should be avoided.
2. Halasana (Plough pose): The plough pose requires you to lie on our back, lift your legs and put them behind your head. This position also requires your heart to circulate blood to the lower body with pressure and against gravity.
3. Karnapirasana (Ear closing pose): This position is similar to halasana, but it requires more efforts, as you have to bring your legs closer to the ground with knees next to the ears. Similar to the halasana, this position exerts pressure on the heart.
4. Sarvangasana (Shoulder stand): This position should be completely avoided as you are standing on your shoulders, with pressure completely on your upper body; the heart has to work against gravity for blood circulation.
5. Sirshasana (Head stand): Similar to the Sarvangasana, Sirshasana is an inverted position. The body is held upright with the support of the arms and the head touching the floor. The legs are held over the heart and hence more pressure is exerted by the heart to pump blood to the lower body.
6. Viparita Karani (Simple inverted pose): This position requires you to lie on your back and raise your legs and slowly lift your hips and support them with your hands. This pose also puts a strain on your heart for blood circulation to the lower body as your legs are above your heart.

Q2: What about PRANAYAM?

First here are some generalized precautions before starting pranayama.
1. If you have any chronic medical condition, seek advice of your doctor and yoga teacher before starting.
2. Always breathe through the nose unless specifically asked to do so.
3. There should not be any strain during pranayama practice. Lungs are delicate organ; ensure that your breathing is not forced beyond limits.
4. Do not make loud sounds during breathing. Keep the breath rhythmic and steady.
5. Pranayama should not be practiced immediately after meals. You can do pranayama at least three hours after meals. Remember a heavy meal will take much longer to get digested. For example if you do pranayama in evening, eat a healthy lunch which gets digested by the time you start pranayama.
6. Beginners should not hold breath. When you become comfortable with basics of pranayama, learn to hold breath under the guidance of an expert teacher after mastering the basics of yoga breathing.
7. Do not practice pranayama if you are too tired, relax for 10-15 minutes in shavasana before doing pranayama.
8. If you do yoga asanas and pranayama, practice yoga asanas before pranayama. After practicing asanas, relax in shavasana before doing pranayama. Do not do any strenuous exercise after pranayama.
9. Pranayama should not be practiced when the lungs are congested.
10. Kapalbhati, bhastrika pranayama is prohibited for people suffering from heart disease, high blood pressure or hernia. For kapalbhati, exhalation must be gentle for beginners, do not use excessive force.
11. Shitkari pranayama is prohibited for people with low blood pressure. Do not practice this pranayama in winters.
12. Agnisar Pranayama should not be done by people with hernia, high blood pressure and also not after any stomach surgery.