Counseling Sheet

Agatha M. Thrash, M.D.
Preventive Medicine

We have had several patients who have had multiple premature ventricular contractions (PVCs) and paroxysmal auricular tachycardia (PAT) to calm down by taking magnesium salts. We use generally magnesium sulfate (Epsom Salts), one half teaspoon in the morning and one half teaspoon in the evening. Dr. C.I. from Texas had complete relief from troublesome PVCs and cardiac arrhythmia after about three weeks of taking Epsom salts. We believe it would be able to keep many people off medication if they were knowledgeable about it.

Heart Rhythm Disturbance (Treat all benign rhythm disturbances as PAT as the natural treatments are the same for all.)

Paroxysmal Auricular Tachycardia (PAT) is a benign, non-threatening condition which causes a good bit of anxiety and discomfort. If prolonged, it may result in exhaustion, but is not life-threatening. Individual attacks may be merely a short run of very fast heart beats, or may last for 10 seconds to 10 hours or more. The heart is usually normal, although PAT may coexist with organic heart disease, such as coronary heart disease. In these cases, the rapid rate may cause significant problems. Our recommendations have two objectives: to prevent attacks and to treat the acute attack and convert to a normal rhythm.

‍Remedies to Prevent Attacks

Exercise‍

Exercise should be graduated for the individual to the point of tolerance. Generally speaking, we should aim at around 5 miles of walking per day (over an hour), or the equivalent in outdoor labor: 2-3 hours of ordinary outdoor labor, gardening, or yard work: or one hour of vigorous and sustained labor - chopping wood or using a shovel. Walking should be vigorous and sustained for one hour, preceded by warmup exercises, and ended by cool-down activities. The warmup period is to prevent skeletal strains, and the cool-down period is to prevent congestion of the chest caused by cooling of the extremities after the forceful beating of the heart has subsided. The aim is to keep the blood circulation balanced between the extremities and the torso. Failure to do so can result in a strain on the heart and lungs.

Persons who have just been exercising vigorously should not immediately drink either hot or cold liquids, as great temperature variation will reduce the blood flow to the extremities, and an extra volume of blood will be retained in the vessels of the trunk. Persons whose deaths have been associated with vigorous exercise usually have had their first symptoms in the immediate post-exercise period, because they sit down immediately and drink a cool drink. Both the cold drink and sitting reduce the circulation to the limbs and increase the volume of blood congesting the lungs, head, heart, and liver: causing blood to move more slowly through the heart, reducing oxygenation.

‍Posture‍

When performing any physical function, whether it be exercising out-of-doors, chopping vegetables in the kitchen, doing shop work, or sitting at the computer, good posture should always be maintained. If the head and shoulders are carried forward during walking, it can lead to neck or shoulder pain. The skeleton should be entirely balanced, one vertebra held directly perpendicular to the one below it as much as possible so that the back and neck are in the "neutral position." The cheek bones should be carried directly perpendicular to the collar bones. Mental and emotional benefits, grace and dignity, self-possession, courage and self-reliance, are all promoted by an erect bearing, as well as keeping the great vessels of the neck in the most favorable position, and allowing the heart plenty of room without squeezing or bending the heart. Keep the shoulders back and down, and the head erect. Practice breathing deeply before sleeping, while sitting at the desk, working in the house, or exercising out-of-doors. Every time you go through a door, take a deep breath.‍

Diet‍

If the weight is above normal, steps should be taken to bring the weight to normal. Rule of thumb: 100 lbs. for the first 5 feet, and 5 lbs. per inch thereafter for women; 6-7 lbs. thereafter for men, depending on musculature. If the weight is already normal or below, no attempt should be made to stuff the stomach with food in the expectation that large quantities of food will make for greater healthfulness. It has been our experience that to be a bit on the thin side is usually helpful for those who have heart symptoms. Generally speaking, concentrated nutrients should be taken sparingly, and that especially refers to nutrient supplements. Of course, all stomach irritants (vinegar, hot spices, alcohol, baking soda and powder) and fermented foods (certain soy sauces, sauerkraut, wine, etc.) should be avoided.

‍Proper clothing‍

The clothing should be adequate to balance the circulation between the trunk and the extremities. It is rare that people, especially women, fully understand how much clothing must be applied to the extremities in order to keep the circulation balanced. If there should be any difference in the clothing, it should be with an excess on the extremities, and a smaller quantity on the trunk, but perfectly balanced is best. While exercising, it is best to have the extremities fully clothed in chilly weather. In hot weather with heavy sweating, the person must not become immobile during the cool-down period with extremities bare, for reasons described above.‍

Drugs and Lifestyle‍

Do not smoke, avoid stress, and never take alcoholic beverages even in small quantities. Coffee, decaffeinated drinks, amphetamines, aspirin, phenacetin, and anything caffeinated including drugs prescribed by a physician must be avoided. Many prescription drugs intensify the symptoms and can make them almost unbearable. If you are taking any medications that can be left off, check with your physician and see if it would not be all right to do so.‍

Herbal Teas‍

Hawthorn berry 2 heaping tablespoons in 1 quart of water. Boil the cracked or ground hawthorn and water together gently for 1/2 hour. Then pour over 2 tablespoons of motherwort and 1 tablespoon of lily of the valley and steep for 30 minutes. Strain and drink the entire quart in divided doses throughout the day. Make fresh daily. May be taken on a daily basis to prevent attacks.

Lobelia has been reported to slow palpitations of the heart.‍

Good natural sources of magnesium

Food / Portion / Magnesium level (mg.)‍

Soybeans, cooked / 1/2 cup / 138
Black-eyed peas, dried, cooked / 1/4 cup / 98
Almonds, whole / 1/4 cup / 96
Tofu / 3 oz. / 95
Cashews / 1/4 cup / 94
Kidney beans, dried, cooked / 1/4 cup / 82
Brazil nuts / 1/4 cup / 79
Shredded wheat / 1 cup / 67
Peanuts, roasted, chopped / 1/4 cup / 63
Walnuts, black, chopped / 1/4 cup / 60
Banana / 1 medium / 58
Avocado / 1/2 medium / 56
Peanut butter / 2 tbsp. / 56
Blackstrap molasses / 1 tbsp. / 52
Potato / 1 medium / 51
Oatmeal / 1 cup / 50
Hawthorn berries contain procyanidines which help stabilize the heart rhythm (Ref. AIZNEIM FORSCH 55;5:490). When the arrhythmia is caused by a lack of oxygen to the heart, ginkgo biloba may be of help. The active ingredient in ginkgo is gindolide D. It has been shown to be as effective as some antiarrhythmic drugs such as Lopressor and Cardizem (Ref. EURO J PHARM 89:164:293-302).

If you get diarrhea from Epsom salts, use magnesium oxide available in health food stores, 2 tablets 3 times a day.

‍Do not overeat. Avoid tight bands around the abdomen; it is best not to bend over within an hour after eating.‍

Be regular in all habits. In addition to daily exercise in the open air where possible, regularity in all things should be maintained. That includes going to bed on time, arising on time, and getting meals and exercise on time. Fresh air, especially in the bedrooms at night, is mandatory.‍ If snoring is a problem, a "snoring collar" can be worn to keep the chin elevated, which reduces snoring. Sleep on one side or the other so the airway is less likely to become obstructed. Sew a large sponge ball or tennis ball on the back of sleep clothing to prevent unconsciously rolling onto the back.

‍Never lie down right after a meal. In many people, the pushing upward of the full stomach against the diaphragm will trigger an attack. Naps should be taken before meals or at least an hour after a meal, 2-3 hours being even better.‍

Treatment of an Acute Attack

• Put feet in hot water for 30 minutes
• Put an ice bag over the heart.
• Deep breathing through the nose, to full capacity for both inhaling and exhaling, 20 to 25 times. Be sure fresh air (not just air conditioned) circulates, or sit outdoors until the attack passes.
• Assume an exaggerated military posture with shoulders back and down, back very straight, head held tall and high, back supported by a chair.
• Change position: if lying, stand: if sitting or standing, lie down: squat, bend over, tilt side to side, etc. Hold each position 6 to 10 seconds before changing.
• Warm the extremities:  extra clothing, hot hand or arm bath, hot foot bath
• Apply firm pressure to one side of the neck or other (not both at once) with the edge of the hand by holding the hand with the palm toward the floor while sitting, and pressing the forefinger edge of the right hand into the left side of the neck, supporting it and adding pressure with the left hand, and holding it for 30 to 60 seconds. If done firmly enough it will be a bit uncomfortable. Alternate hands and sides of neck.
• Press the fist forcefully into the V-shape made by the ribs over the stomach, putting additional pressure with the opposite hand. Hold 30 to 60 seconds.
• Have someone massage the feet, pressing the thumbs into the soles. Continue 5 to 15 minutes.
• Drink a hot liquid: water, hot garlic tonic (one cup of boiling water in blender with one clove or one teaspoon of garlic powder - no salt - blenderized until smooth), or hot tea. Instructions below.
• Herb teas: hawthorn berry tea, 1 cup every 10 minutes for an hour. Catnip or valerian teas are helpful for the anxiety which may be associated with the attacks. Use one cup of tea as needed.
• Take one teaspoon of Epsom Salts (magnesium sulfate) or 3 tablets of magnesium oxide with one glass of water or hawthorn berry tea.
• Allow no passive smoke in the air. Drink no coffee or ordinary grocery tea; use no drugs, aspirin, or other medication as any drug can cause cardiac arrhythmias.
• Mix one tablespoonful of charcoal with approximately one tablespoonful of olive oil and swallow, using a bit of water if necessary.

Case History

One woman in her mid-thirties called complaining of frequent bouts of supraventricular tachycardia. She reported that she would have bouts with her heart rate as high as 200, and had had to be hospitalized a number of times. She was averaging having to go to the emergency room approximately every 3 weeks. When she called she had tried virtually every antiarrhythmic drug her doctor could find with little or no help. She had an extensive medical workup and no heart disease had been found other than the rhythm disturbance.

We suggested that she take a totally vegetarian diet, without free fats and with no animal protein, especially avoiding milk products since they have been reported to trigger cardiac arrhythmias. We also suggested that she take two capsules of hawthorn berry tea 4 times a day, and a preparation containing magnesium and potassium orotate (both potassium and magnesium have been found to be low in some patients with heart disease and/or benign arrhythmias). We advised her to walk moderately, building up her exercise tolerance until she was walking at least 2 miles a day. She called back about a month later saying she was doing considerably better with only occasional mild attacks of tachycardia and no hospitalizations.

For a year, she had no serious symptoms. Then she had to have some minor surgery requiring a general anesthetic. She forgot to take either the herb or the supplement to the hospital with her. She had taken a low-salt diet before hospitalization, but her diet in the hospital had contained considerable fats as well as salt. She went through the surgery successfully, and came home within 3 days, but 2 days later had an attack of tachycardia which lasted for an hour. As she was preparing to go to the emergency room, it abruptly stopped. Her problem settled down after resuming her program, and she has had no further recurrences of the tachycardia in one year.