A Medics view of Hawthorn ?!

[Guest guest]

This is a plea for herbal support in therapeutics and dealing with Professors of

medicine!

Sorry for its length but all interesting stuff!

For 2 months I have been treating an 84yr man who has severe angina symptoms

(stabbing/griping chest pain spreading to L arm, SOB), TIA 6/7 x yr , But has

never had

high BP and has PMH of low BP and now episodes of bradycardia 4 x wk and

dizziness,

fainting and giddiness. Also nightmares of past war experience wakes. Pain

worse for

exercise, cold, bowel motion, eating, nightmares, but also occur when sitting

reading, etc.

PMH rheumatic fever as child, war trauma (much healing done already), '73 arm

aches

which remitted on rest, '74 surgery for volvulus and resection of colon later,

'78 chest pain

and diagnosed as angina, '79 MI and R CVA, '80 chest pains worse diagnosed as

angina

due to coronary artery spasm (cause of spasm never found out), '83 resection of

prostate,

'83 R CVA, '89 mutiple pulmonary emboli, '92 L CVA. Upto present day patient

has had

several moderate CVA's and TIA's and was referred to Brompton Hospital in '97

and has

had medication adapted several times including a L Thoracic Sympathectomy(

Helped for 8

mths only and has Horner's syndrome now), and the insertion of a spinal cord

Stimulator

which worked okn for 5 yrs. Angioplasty with stent had no effect. Has had neck

xrays and

much other poking about as you get the picture! So his medication now is

Clopidogrel

(antiplatelet), aspirin, Diltiazem (Ca channel blocker), Nicorandil (Potassium

channel

activator and vasodilating), fish oils, and when needed oxygen and Diamorphine

injection

both becoming more needed. BP 120/70, increases with pain episode, pulse 60

decreases

with bradycardia to 45. Family history of CVA. Phew! So very complicated not

your

classic angina with high BP and has been difficult finding remedies to suit.

Professor at Brompton Hospital has replied to a letter I wrote requesting

treatment with

Crataegus. He thinks this would be dangerous because of it's " digitalis "

effect and dispite

my attempt to explain the huge differences between Hawthorn and Digitalis he is

not

buying it. So for interest this is what he wrote " Dear Ms Walters, We are not

going to

agree on this matter. I enclose a number of publications relating to the

cardiac and other

effects of hawthorn extract. The positive inotropic effect is thought to be due

to the

inhibition of the sodium potassium ADPase. That is the digitalis effect.

Warnings are

everywhere concerning the interaction between Digoxin and hawthorn. I am

unclear what

is the indication for giving this patient hawthorn. The diagnosis is complex

and unusual

so previous experience with hawthorn in such a situation is probably rather

limited. In the

presence of possible ischaemic episodes there is a potential for serious

adverse events.

Yours sincerely............... " Publications given were of an investigation of

Crataegus Extract

WS 1442 (?? whats that??!!) in 2000 in European Journal of Heart Failure 2

(2000) 431-437

and ACCF Complementary Medicine Expert Consensus Document anyone interested just

get in touch...!

I had sent him several monographs on Crataegus and bear in mind the patient is

not on

cardiac glycosides (Digoxin). What do reckon to his letter? And does anyone

have any

experience or indepth knowledge of the actions of Hawthorn more than I thought I

knew?

I plan to write back but want to have some good material for him......So any

thoughts

much appreciated. And in a positive light herbal treatment so far has improved

bowel

function, sleep and given more energy and positivity during pain episodes. But

any more

ideas are much appreciated!!

This has been a really difficult case in more ways than one and the professors

reply really

rocked my herbal boat for some reason, perhaps it was the abruptness, I live in

hope they

are not all dragons.....

happy elderflower champagne making! from X