The Heart Health India Foundation (HHIF) continues to advance its commitment to bringing evidence-backed, patient-centred care into public conversation through its Dil Ke Doubts sessions—an open platform designed to connect patients, caregivers, and medical professionals. The goal is to enable timely, relevant dialogue on pressing concerns related to heart health. Our recent Dil Ke Doubts session, held on 15 July 2025, brought these values to life through a warm and informative conversation with Dr Ambalam M Chandrasekaran, Senior Consultant at the Centre for Chronic Disease Control and a leading voice behind the Yoga‑CaRe programme. The session was held around International Yoga Day and focused on how yoga can complement traditional cardiac rehabilitation for those recovering from heart events or looking to safeguard their heart health.
This session focused on a frequently asked but often misunderstood question: Can yoga play a role in heart recovery and prevention? What followed was a clear and empathetic explanation of the scientific foundations, limitations, and practical guidance around integrating yoga in heart care—particularly after events like heart attacks or angioplasty.
Many Heart Patients Are Left Wondering What Comes Next After Medical Treatment Ends
For most individuals recovering from a heart attack, angioplasty, or related cardiac procedure, the discharge from the hospital is not the end of their health journey—it’s the beginning of a long-term commitment to recovery. Unfortunately, many are left with unanswered questions: What exercises are safe now? How can anxiety and fear of recurrence be managed? Is medication alone enough? How does one go back to “normal life” with a changed heart?
The answers are not always easy to find, especially in India, where structured cardiac rehabilitation programmes are limited in reach and often inaccessible to a majority of patients. There is a pressing need to promote models of care that integrate medical management with lifestyle and behavioural changes, particularly in the context of non-communicable diseases such as heart disease.
Dr Ambalam Brings Decades of Research and Clinical Practice Into Patient-Centric Dialogue
Dr Ambalam Chandrasekaran’s work has focused on chronic disease prevention and rehabilitation through non-pharmacological approaches rooted in evidence. As a senior clinical researcher and public health practitioner, he has contributed to the design and implementation of the Yoga‑CaRe programme—a structured and clinically evaluated cardiac rehabilitation model based on yoga practices.
In this session, Dr Ambalam shared how Yoga‑CaRe was developed through multi-country trials and tailored for patients recovering from acute cardiac events. It includes components like safe physical activity, breathing practices, stress management, and lifestyle counselling—customised for individual needs and health conditions.
His explanation helped patients and caregivers understand that yoga is not merely a philosophical or spiritual pursuit—it is a practice grounded in physiology, mental health, and behaviour change science.
Patients Asked Practical and Emotionally Charged Questions Reflecting Real-Life Concerns
The session saw active participation from heart patients and their families. Many questions reflected a deep need for clarity, reassurance, and direction.
One recurring theme was: “What should I do now to prevent future events?” Dr Ambalam provided a layered response. While taking medication as prescribed is non-negotiable, real recovery depends on adopting a heart-healthy lifestyle. This includes:
- A balanced, low-sodium and nutrient-rich diet
- Daily physical activity tailored to the patient’s capacity
- 6–8 hours of quality sleep
- Avoidance of alcohol, smoking, and stress triggers
Yoga fits into this model as a low-cost, accessible, and adaptive tool for self-regulation—physically and emotionally. Breathwork (pranayama), gentle movements (asanas), and relaxation-based practices are useful in regulating heart rate, calming the nervous system, and reducing fear and anxiety.
However, Dr Ambalam emphasized that no one should attempt yoga without medical consultation. Ideally, it should be introduced under the supervision of a certified yoga and naturopathy practitioner (BNYS) or a trained health professional who understands both yoga and cardiology.
Yoga Can Help Manage Symptoms, But It Is Not a Cure for Structural Heart Conditions
A number of participants raised specific questions around heart function metrics—especially Ejection Fraction (EF)—and whether yoga could help improve it. Others mentioned complex diagnoses like Dilated Cardiomyopathy (DCM) and atrial flutter.
Dr Ambalam was clear in his response. While yoga cannot reverse structural damage or cure progressive conditions like DCM, it plays a supportive role in symptom management and psychological well-being. For example:
- In patients with low EF, carefully structured yoga can support cardiovascular efficiency.
- In atrial flutter, yoga may help reduce the frequency of episodes by promoting autonomic balance and stress relief.
- For general fatigue, sleep disturbances, and fear of recurrence, yoga has proven benefits.
However, these gains are incremental and vary widely by patient condition. Yoga is never a replacement for standard medical care or cardiology follow-ups.
Not All Yoga Poses Are Suitable for Cardiac Patients and Some Should Be Avoided Entirely
One commonly asked question was whether patients could resume Surya Namaskar (Sun Salutation). Dr Ambalam cautioned strongly against this for those who were not already practising it prior to their cardiac episode. The dynamic sequence can place undue strain on the heart if performed without conditioning.
Instead, a gentler approach is preferred:
- Seated or lying-down postures
- Slow breathing and guided pranayama
- Mindfulness-based relaxation
- Avoidance of inverted or intense balancing poses
A sample daily routine may include 10–15 minutes of breathing, 15 minutes of gentle stretches, followed by 10 minutes of guided relaxation or meditation. Importantly, this must be individualised and should be reviewed periodically by a medical professional.
There Is No Age Limit to Starting Yoga, But It Must Be Introduced Gradually
Participants also sought clarity on preventive practices. Could someone above 60 begin yoga? Could a healthy individual stop medications if they were feeling well?
Dr Ambalam addressed both with scientific rigour and compassion:
- Age is not a barrier. Yoga can be started at any point in life if approached gradually.
- Feeling healthy does not justify discontinuing prescribed medication. Cardiac risk can exist even in asymptomatic individuals.
- Prevention is not only about diet or exercise—it is also about regular screening, stress management, and understanding one’s unique risk profile.
Starting late is better than not starting at all—but the key lies in sustainability, not speed.
In Complex Conditions Like Valve Leakage or Cardiomyopathy, Yoga Enhances Coping Capacity
Patients with structural conditions such as valve defects, congenital heart problems, or advanced DCM often feel excluded from exercise-based advice due to their condition complexity. One participant asked whether yoga could benefit them at all.
Dr Ambalam clarified: while yoga will not correct valve leakage or serve as treatment for DCM, it enhances overall quality of life. It improves:
- Sleep
- Appetite
- Anxiety levels
- Fatigue tolerance
- Sense of agency and emotional resilience
Even in medically complex cases, there is space for a non-strenuous, safe yoga practice tailored to the individual.
Scientific Evidence Exists to Support Yoga’s Role in Cardiovascular Care
There was a request during the session for data supporting yoga’s clinical value. Dr Ambalam referred to more than 40 peer-reviewed studies available on PubMed, many of which are based in India and include data on:
- Blood pressure reduction
- Stress hormone regulation
- Patient-reported wellbeing
- Improved adherence to lifestyle advice
The Yoga‑CaRe programme itself has been evaluated through randomised controlled trials and is one of the few scalable rehabilitation models designed for low- and middle-income countries.
A Peer-Driven, Trusted Community Like HHIF Can Bridge the Post-Discharge Care Gap
The most important insight from the session was this: the need for community does not end with treatment. In fact, for most patients, the period after discharge is when emotional and practical challenges intensify.
Dil Ke Doubts sessions are designed to address exactly this gap—by giving patients and caregivers a chance to ask questions, hear from experts, and feel part of a support structure. It breaks isolation, builds shared understanding, and promotes better decision-making.
HHIF is building not just content, but connection. Through WhatsApp groups, expert sessions, patient support tools, and storytelling, the organisation is redefining what patient-led advocacy can look like in India.
Frequently Asked Questions (FAQs)
1. Can yoga replace medication after a heart event?
No. Yoga is a complementary practice, not a substitute for medication. Always follow your doctor’s treatment plan.
2. Is it safe to do yoga right after angioplasty?
Only after medical clearance. Typically, gentle yoga may begin 4–6 weeks post-procedure under supervision.
3. Can yoga improve my low ejection fraction (EF)?
Yoga may support cardiovascular efficiency but is not guaranteed to raise EF. Benefits are gradual and vary individually.
4. What types of yoga are safe for heart patients?
Gentle stretches, breathing exercises, guided relaxation, and mindfulness are safe. Avoid vigorous or inverted poses.
5. Can yoga help with anxiety and palpitations?
Yes. Practices like pranayama and body relaxation help regulate the nervous system and reduce anxiety symptoms.
6. Is Surya Namaskar safe after a heart attack?
Not unless you were practising it earlier and only with expert supervision. It is not recommended for beginners.
7. Can someone aged 60+ start yoga safely?
Yes. Age is not a barrier. Start slow, go gentle, and consult a trained yoga medical practitioner.
To join HHIF’s patient support community, ask more questions, or attend future sessions, visit www.hearthealthindia.org or scan the WhatsApp link on the website.
Heart health is not just about medical facts—it is also about support, choice, and understanding. HHIF is here for all three.
Ram Khandelwal (Founder of HHIF), Aditi Khandelwal (Co-Founder)
