Complementary Alternative Cardiovascular Medicine

250 Alternative Cardiovascular Medicine
bance can manifest as depression, anger, frustration, or fear. Mood has
a powerful influence on prognosis after acute MI (36). Despite all the
reassurance that surgeons and nurses can give, most patients who are
awaiting cardiac surgery experience anxiety, and some experience fear.
The fear is mainly about uncontrolled pain. McCaffrey (37) found that
a combination of pharmacological and nonpharmacological methods of
pain control produced the best results. As mentioned in an earlier part of
this chapter, fear and anxiety are governed by the amygdala (38), and the
amygdala is influenced by aroma.
Gentle touch can do much to allay fear and anxiety (39). The effect of
touch is greatly enhanced when the patient learns to associate relaxation
with touch and specific aromas preoperatively (40). Smell and touch are
two powerful nonverbal communicators and may help those patients
who are unable to communicate verbally through lack of language or
other skills.
Roman chamomile and lavender reduced anxiety in a small
noncontrolled pilot British study by Hadfield (41). Eight patients with
primary malignant tumors were given aromatherapy in a hand, foot, or
neck massage during their first follow-up appointment after commencing
radiotherapy. Patients completed Hospital Anxiety and Depression
Scales (HADA) immediately before the aromatherapy and 24 h after the
therapy. The results indicated a statistically significant reduction in all
physical parameters.
Gould et al. (42) reported on the relaxing cardiac effects of chamomile
tea with a group of 12 hospitalized patients who had undergone cardiac
catheterization. They found that there was a small but significant rise in
the mean blood pressure. However, they were more struck that 10 of the
12 patients fell into a deep sleep within 10 min of drinking the tea.
Sleeping was a rarity during this procedure. Patients had not been premedicated
and received no other sedation during the procedure. The
chamomile tea had essentially no cardiac effect. This is not aromatherapy
but a commonly accepted form of aromatic medicine (like coffee and
tea). Essential oils are up to 100 times stronger than an herbal tea. Yamada
et al. (43) found that chamomile essential oil reduced stress-induced
increases in plasma ACTH levels in rats and suggested that essential oil
of Roman chamomile might be useful against stress in humans. Avollone
et al. (44) studied an aqueous extract of German chamomile flowers, and
it behaved as both central and peripheral benzodiazepine receptor
ligands, with anxiolytic effects. However, the compounds responsible
for this action were unknown. Viola et al. (45) attempted to identify the
compound in a further paper. German and Roman chamomile are different
essential oils. Roman chamomile may be more useful in a cardiac