A Heart Case Study with yoga therapist Montserrat G Mukherjee

A woman laying down on a yoga mat.

Our heart case today is Wanda (not her real name), a 65-year-old woman, diagnosed with high blood pressure and cardiac arrhythmia (irregular heartbeats which flare up during times of stress).

She has also two artificial titanium knees, which were successfully operated ten years ago. She has some small physical limitations such as that she is unable to bend her knees fully, and she has pain around the knees with certain positions like sitting cross-legged and balancing standing poses.

She has a wonderful, funny, strong character, and she carries all the weight of a successful family business. Her two grown-up daughters work for her, and she tends to worry about them and be quite involved in their lives.

Active and stressed

Wanda goes to the gym twice a week under the supervision of a cardiology physiotherapist, and she plays golf once a week. She is physically active, although she is under a lot of stress at work and she has a tendency to enjoy late nights, alcohol, and the odd cigarette.

Recently, Wanda suffered a TIA (Transient Ischemic Attack), which left her temporarily unable to speak. The symptoms of high blood pressure and heart palpitations are currently under control through medication, but she is still a risk-student and challenging case, in Yoga Therapy terms.

She has been coming for Yoga Therapy sessions one time per week for the past year Wanda is actually very flexible – her joints are slightly hyper-mobile, which would also explain the problems with her knees, and she specifically comes to Yoga Therapy for stretches and relaxation, especially Yoga Nidra, which, no wonder, she loves.

The class

I wanted to share this story because today we took a different approach. Our class was at 2 pm, on a sunny, lazy afternoon. Wanda shared some of her personal worries as we started the session. She was angry about some family issues and soon I was able to notice tiredness creeping in.

As she is already quite active and has quite a lot going on in her mind, I generally tend to bring Wanda down to the floor, to rest.

“Inspired by our Yoga Therapy training in Haarlem last week, instead of introducing Restorative Yoga at the end of the class, we practised stretches in fully supported positions from beginning to end.”

A heart case Meditation cushion under the head, rolled “flat” cotton blanket under middle back, bolster supporting and lifting knees, another cushion supporting ankles and feet.

A heart case Rolling on the side, breath directed to the blanket under the side ribs. Change side after a few minutes.


A heart case Side child pose, direct the breath to the cushion on the lower back.

Notice from the images above, that Wanda’s head is fully supported with a yoga cushion, slightly more elevated than we would normally do with other students.

This is because Wanda has high blood pressure, and although she is on medication, she is considered a high-risk student – as we said – due to her medical history, age, and her lifestyle.

So, at all times her head, neck, and face were relaxed, and she kept on making noises of happiness through the poses!

Back breathing

Through these supported stretches, I invited her to breathe toward the back. A typical aspect of heart disease is the build-up of tension areas behind the chest, which can be even physically seen in the form a “hump” in the middle back. Directing the breath to this area and placing strategic blankets along and across the spine (so she can breathe into the blanket) helped her focus on the release of the middle back area.

Wanda loved today’s session, which we followed with a simple Yoga Nidra in fully supported Shavasana for 15 minutes. By the end of the session, she felt calmer, rested, and left in a wonderful light mood with a big smile on her face. Amazing results, when all we did was talk, ground, support, breathe and rest. Sounds to me like a good recipe for us all.

With a heartfelt wish,



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