Hrudaya Marma and Dasha Dhamani in Relation to Contemporary Cardiovascular Anatomy: A Narrative Mini Review of Sinotubular Junction Diameter Variations

Abstract

Background: In classical Ayurveda literature, the Hrudaya (heart) is conceptualized as a supreme vital node, designated as a Sadhya Pranahara Marma (vital anatomical point causing sudden death upon injury). It is intricately connected to the Dasha Dhamani (ten great vessels). While the functional anatomy has been explored, the specific metrological and structural correlations of the proximal great vessels—particularly the ascending aorta and its sinotubular junction (STJ)—remain underexplored in integrative medicine. Objectives: To critically analyze classical Ayurveda concepts of Hrudaya Marma and Dasha Dhamani, correlating them with the contemporary anatomy and clinical pathology of the aortic root, STJ, and ascending aorta. Material & Methods: A comprehensive narrative review was conducted using classical Ayurveda texts, authoritative commentaries (e.g., Pratyaksha Shareera), and contemporary cardiothoracic, embryological, and imaging literature sourced from major electronic databases. Results: Textual measurements of the Aarohini Mahadhamani (ascending great vessel)—documented as two Angula (fingerbreadths) in length and five Angula in circumference—correspond with striking precision to the human ascending aorta. Its three Kotara (alcoves/pockets) represent the aortic sinuses. Furthermore, contemporary observational evidence indicates that the STJ diameter, particularly when indexed to body surface area, is an independent predictor of acute type A aortic dissection. Conclusion: Correlating the ancient metrological framework of Hrudaya Marma with modern STJ and aortic root paradigms validates traditional Ayurveda quantitative anatomy. This synthesis provides a robust translational framework for preventive cardiology, emergency medicine, and forensic analysis.