First Report Of 50-Day Continuous Fasting in Symptomatic Multivessel Coronary Artery Disease and Heart Failure: Cardioprotection Through Natural Ketosis.

A 64-year-old man with angina and dyspnea due to severe two vessel coronary artery disease (CAD) was recommended for revascularization. The patient had recently learned Siddha fasting and self-inquiry meditative methods at Heartful Living, our eight-week physicianled cardiac wellness group clinic. He declined coronary artery bypass surgery and instead self-initiated a 50-day water-only fast and then switched to a vegan diet. During the fast, the patient experienced severe dehydration and electrolyte abnormalities, requiring IV fluids and electrolyte replacement. However, his hemodynamics remained stable and he had no angina, likely due to natural ketosis mediated cardioprotection. This is the first report of such a prolonged fast targeting cardiac resilience and clinical benefits in severe CAD. Copyright 2022 by the Missouri State Medical Association.