Traditional Chinese Internal Medicine Heart Disorders

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Internal Medicine – Heart Disorders

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Always Tired

Angina

Depression and Manic Psychosis

Insomnia

Palpitation

Acupuncture treatment of Chest pain

 

Important: as with all items posted on TCM Health-info, it is very strongly recommended that you seek proper advise from your healthcare professional before administering any form of treatment to yourself.  This website is for informational purposes and does not replace the proper diagnosis of your physician. 

 

Overview Of Heart Function:

The heart governs blood in two different ways.  It is the area where food Qi (Gu Qi) is transformed into blood.  The heart Qi is the main organ responsible for moving blood within the blood vessels in order to transport blood to all tissues of the body.  The heart houses the body’s Shen.  Shen indicates the mentality of an individual while it also shows the emotional and spiritual aspects.  So it not only relates to the heart but it includes emotions, mentality and spirituality of the bodies overall constitution.  Disorders of the heart include, excessive tiredness, angina, insomnia, depression, manic psychosis and palpitations.

 

Click here for more TCM Heart Foundations:  Functions of the TCM Heart

 

 

 

Always Tired – Duo Mei

Top of the Document

The patient can sleep anywhere or anytime no matter how much sleep they have received.  They may wake up in the morning and keep on sleeping through out the day, fatigue is so bad that patient will be unable to work.  Is usually caused by Yang Qi Deficiency.

 

Western Medicine

            Chronic fatigue, Bi polar or Narcolepsy

 

May Be Caused By:

 

            Accumulation of Phlegm and Damp:

                        Phlegm & Dampness (yin pathogens) block yang Qi

            Spleen Qi Deficiency:

Creates Qi & Blood deficiency – body not nourished, whole body becomes flaccid

            Kidney Yang Deficiency:

                        Old age/chronic illness – bones, mind, essence and spirit all become weak

            Traumatic Injury/Blood Stasis:

                        Qi & Blood do not circulate creating deficiency

            Sudden Shock/Fear:

                        Causes Qi stagnation- Qi doesn’t ascend to brain

 

 

Damp Accumulation (blocks spleen Qi)

            Heaviness in head and limbs, edema, poor appetite, fullness in chest, nauseous

                        T – greasy, swollen                                                       P – soft

            Treatment:        Dry Dampness and strengthen Spleen Qi

            Formula            Tai Wu Shen Zhu San

 

Turbid Phlegm Stagnation

Heaviness in head and limbs, poor appetite, fullness in chest, nauseous, over weight

            T – greasy, swollen, sticky                                P – slippery

Treatment:        Eliminate Phlegm and invigorate Spleen.

Formula            Wen Dai Tang

 

Spleen Qi Deficiency

Unable to stay awake after meals, poor appetite, soft stools, spleen Qi deficiency symptoms

            T – pale, puffy, teeth marks                               P – soft, weak

Treatment:        Strengthen spleen Qi and eliminate dampness

Formula            Xiang Sha Lu Jun Zi Tang

                        Bu Zhong Yi Qi Tang (spleen Qi sinking)

 

Kidney Yang Deficiency

Spleen Qi deficiency symptoms with cold symptoms, lack of concentration, poor memory

            T – pale                                                            P – deep, thin

Treatment:        Nourish Kidney Yang

Formula            Fu Zi Li Zhong Tang

 

Blood Stasis

            History of traumatic injuries, H/A, sleepiness with cloudy dizziness

                        T – purple                                                        P – uneven

            Treatment:        Promote blood circulation and remove blood stasis

            Formula            Tong Qiao Huo Xue Tang

 

 

 

Angina – Heart Pain – Xin Tong

Top of the Document

Angina is  a cramping pain in the chest which can radiate to the shoulder blade, down the left arm and up the throat to the teeth.  Heart pain can also be accompanied by palpitations, shortness of breath and a distended or fullness feeling behind chest. 

 

Western Medicine:

            Angina is a lack of oxygen supply to the heart itself causing pain.  This is often caused by coronary Heart disease causing Heart Attacks or inflammatory heart diseases.

 

May Be Caused By:

            External Pathogen Invasions:           -Ext. Cold- stagnates Heart meridian Qi

                                                                        -Summer Heat – Injures Heart meridian Qi

            Emotion                                              -over thinking, worry, anger, joy, sad, fear

Diet                                                     -injures spleen producing Phlegm which blocks Heart meridian Qi.

Deficiency                                          -chronic illness & over work injures Qi & Blood

                                                            -Liver and Kidney Deficiency – injures Heart

 

Differential Diagnosis:

ST Ache     -lower pain which does not radiate into the chest and down the left arm.   Accompanied by belching, flatulence, acid regurgitation

Hypochondriac-Chest Pain

                        -related with cough and febrile disease history, accompanied by liver Qi stagnation symptoms.

 

 

 

Heart Meridian Blocked By Cold

Sudden onset of heart pain which radiates to back, usually in cold season or sudden cold weather, cold body with cold sweat, palpitations. 

            T – slight purple, thin white coat                        P – tense

Treatment:        expel cold and remove stagnation to relieve pain

Formula            Dang Gui Si Ni Tang

 

Stagnated Fire Attacking Heart

            Burning heart pain, thirsty, irritable, rough breathing, fever, constipation.

                        T- red, yellow coat                                           P – rapid

Treatment:        Purge fire, clear heat to remove stagnation and promote blood circulation.

Formula            Xiao Xian Xiong Tang

 

Qi Stagnation in Heart       

Fullness in chest and Heart with moving dull pain.  Pain agg. By emotional stress. Accompanied by Qi stagnation symptoms.

            T – pale, purple, red tip                                    P - wiry

Treatment:        soothe liver and regulate Qi to relieve pain.

Formula            Chai Hu Shu Gan San

 

Blood Stasis

            Severe heart pain, stabbing, squeezing fixed pain

                        T – purple veins under tongue                           P – uneven, irregular

Treatment: promote blood circulation and remove blood stasis to relieve pain

            Formula            Xue Fu Zhu Yu Tang

 

Phlegm Stasis

Heavy oppression in chest, difficult breathing, agg. During damp weather, productive cough, soft stool, sticky sensation,  nautious, phlegm/damp symptoms

                        T – purple, thick greasy coat                                         P – wiry

Treatment:        Eliminate phlegm, clear heat/wind, invigorate Qi to relieve pain.

            Formula            Gua Lou Xie Bai Ban Xia Tang

                                    Wan Dan Tang – Phlegm Heat – dry stool, dysphasia

                                    Di Dan Tang     - Phlegm Wind – numbness/dizziness

 

Heart Qi Deficiency

Dull pain, short of breath, agg. By activity, pale complexion, spontaneous sweat

                        T – pale                                                            P – weak, deep

            Treatment:        Nourish heart Qi

            Formula            Bao Yuan Tang

 

Heart Yin Deficiency

            Dull burning pain, insomnia, dysphasia, palpitations

                        T – red tip, scanty coat                                     P – rapid, thin

            Treatment:        Nourish heart Yin

            Formula            Tian Wang Bu Xin Dan

 

Heart Yang Deficiency

Pain and palpitations, almost can’t function, fatigued, cold, agg by cold and exertion

                        T – pale                                                            P – weak, deep

            Treatment:        Nourish yang Qi and invigorate heart Yang

            Formula            Ren Shen Tang

                                    + Shen Qi Wan  - KD yang def.

                                    + Zhen Wu Tang  - edema

 

 

Depression And Manic Psychosis – Bipolar

Dian Kuang

Top of the Document

Depression (Dian) is the emotional state of being sad or extreme feelings of dejection, lack of worth and emptiness.  Signs of depression (Dian) range from lack of motivation, failure to concentrate, lack of expression on ones face, quiet, and in severe conditions body functions can be effected. Manic Psychosis or Mania (Kuang) is a mood disorder where there is excess excitement, nervousness, excess talking, loud talking, and possible violent – destructive or self-destructive behaviour.

 

May be caused by:

 

Qi Stagnation             -Liver/Spleen stagnation produces phlegm & blood stasis blocking Heart meridian and blocks the mind

Phlegm                        -blocks mind

Fire                             -more for Kuang behaviour- fire effects (St/LV/GB) which then attacks Heart and blocks the mind.

Blood Stasis               -blocks healthy Qi & Blood from nourishing Heart & mind.

 

Depression - Dian

 

Phlegm Stagnation

Lack of expression, retarded mental activity, paranoid, talk to themselves, suicidal, poor appetite

            T – white/greasy coat                            P – wiry, slippery, deep

Treatment:        Soothe liver Qi and eliminate phlegm to clear mind

Formula            Xiao Yao San  & Di Tan Tang or Er Chen Tang

 

Qi Deficiency With Phlegm Stagnation

Very quiet, dull yellow complexion, soft stools, lack of expression, retarded mental activity, paranoid, talk to themselves, suicidal, poor appetite

                        T – pale, swollen, white/greasy coat                  P – weak, soft, slip.

Treatment:        Strengthen spleen Qi and eliminate phlegm to clear mind

            Formula            Si Jun Zi Tang + Di Tang Tang

 

Qi & Blood Deficiency

Pale, fatigued, lack of concentration, easily shocked, palpitations, easily sad, easily cry, no courage, disturbed sleeping patter, HT/SP deficient patterns

            T – pale, teeth marks, thin/greasy coat               P – weak, thin

Treatment:        Nourish Qi/Blood/Heart & spleen to clear mind

Formula            Yang Xin Tang

 

 

Manic Psychosis - Kuang

 

Phlegm Fire

Acute onset, insomnia, H/A, irritable, red complexion, red eyes, angry eyes Severe case – violent, sweating, shouting

            T – red, yellow/greasy coat                               P – slippery, rapid

Treatment:        Induce vomit then – Purge bowel movement to eliminate phlegm

Formula            San Sheng Tang = induce vomit

                        Xie Xin Tang + Gun Tan Wan = purge phlegm

 

Yin Deficiency With Hyperactive Fire

Fatigued with irritability, anxious, insomnia, easily shocked, red complexion, emaciation

                        T – red, thin coat                                              P – thin, rapid

            Treatment:        Nourish yin and descend fire to calm the mind

            Formula            Er yin Jian + Din g Zhi Wan

 

Qi & Blood Stagnation

May occur after traumatic injury or related to menses, H/A, heavy menses with clots, severe PMS, abdominal pain, irritability, insomnia, red complexion

            T – purple, thin/yellow coat                               P – thin, wiry, rapid

Treatment:        Promote blood circulation and regulate Qi to relieve stagnation

Formula            Dian Kuang Meng Xing Tang + Tao Hong Si Wu Tang (mild)

                        Or + Da Huang Zhi Cong Wan (severe)

 

 

 

Insomnia – Shi Mian

Top of the Document

Insomnia is the chronic inability to sleep not being able to achieve deep sleep.  Most people who suffer insomnia will be unable to sleep through out the night with ought waking frequently.  The primary organ affecting sleep is the heart, which is usually accompanied by a secondary organ which is dysfunctional.

 

May Be Caused By:

 

            Emotions:

                        All 7 emotions may cause dysfunction–Joy (HT)has most impact on sleep

                        HT – Joy – shen/spirit doesn’t calm at night – HT looses control

                        LV – Anger – can’t store blood – liver turns to fire attacking HT

                        SP – Worry/Sad – SP Qi stagnates and can’t T&T Blood to nourish HT

            Spleen Deficiency:

Caused by diet/poor digestion or over working – can’t produce blood to nourish HT

            Heart & Kidney Disharmony:

                        Causes a disharmony between kidney water and heart fire

            Liver Blood Deficiency:

                        Liver can’t store ethereal soul – soul becomes active and eyes will not shut

            Heart & Gall Bladder Qi Deficiency:

                        Impairs heart function – GB can’t ascend or disperse – timid person

            Phlegm Heat in the Liver / Heart:

                        Phlegm heat entraps heart and mind

            Disharmony of Stomach Qi:

                        Follows divergent meridian impairing heart

 

 

Heart & Spleen Deficiency

Difficulty falling asleep, excessive dreaming, easily awakened, hard

 to fall back to sleep,  HT blood def. symptoms with SP Qi def.

symptoms

            T – pale, white coat                                          P – weak, thin

Treatment:        Nourish Heart and Spleen to calm the mind

Formula            Gui Pi Tang

                        Liu Jun Zi Tang – more SP Qi def. symptoms

                        Suan Zao Ren Tang – more HT Blood def. symptoms

 

Heart Yin Deficiency with Hyperactive Fire

Difficult sleeping with irritability, chest dysphoria, yin def. symptoms, dry throat, thirsty, mouth sores, cankers

            T – red, dry coat                                              P – thin, rapid

Treatment:        Nourish Yin, clear Heart fire and calm the mind

Formula            Tian Wang Wu Bu Xin Dan

 

 

Heart and Kidney Disharmony

Difficult sleeping with dysphoria, reproductive disorders, lower back/knee weakness and pain, KD essence def. symptoms.

            T – red tip, scanty coat                                     P – thin rapid

Treatment:        Strengthen Kidney to balance Kidney and Heart to calm mind

Formula            Jiao Tai Wan

 

Liver Blood Deficiency

Difficult sleeping, wakes frequently with great difficulty falling back asleep, excessive dreaming, easily angered, hypochondriac/chest pain/fullness, liver stagnation symptoms

            T – red sides, white/yellow coat            P – wiry, rapid (if heat)

Treatment:        Nourish Liver Blood and sooth Liver to calm the mind

Formula            Suan Zao Ren Tang

Dan Zhi Xiao Yao San + calming herbs (Liver Heat Turns to fire)

 

Heart & Gall Bladder Qi Deficiency

Difficult sleeping, timid character, always thinking, can’t make decisions, depression, spontaneous sweat, palpitations, short of breath

            T – pale                                                            P – thin, wiry

Treatment:        Nourish Ht and Gall Bladder Qi to calm the mind

Formula            An Shen Ding Zhi Wan + Ren Shen + Fu Ling (to nourish Qi)

 

Phlegm Heat

Difficult sleeping with dizziness, blurred vision, fullness in chest, bitter taste, nauseous, phlegm vomit, belching, overweight

            T – red, greasy yellow coat                               P – slippery, rapid

            Treatment:        Eliminate Phlegm and clear Heat to calm the mind.

            Formula            Wen Dan Tang

 

Stomach Qi Disharmony

Difficult sleeping, nauseous, vomit, bloating, irregular bowel movement, abdominal distension/pain, irregular diet

            T – greasy coat                                                 P – slippery

Treatment:        Remove Stagnation in Stomach, promote digestion and harmonize ST Qi to calm the mind.

Formula            Bao He Wan + Chen Qi Tang (constipation)

 

Palpitations – Xin Ji

Top of the Document

Palpitations are the pounding or racing of the heart and may be accompanied by shortness of breath, fatigue and an irregular pulse which may be short and fast or rapid.   Palpitations are usually due to lack of support from another organ creating a Heart deficiency or an external pathogenic factor blocking the Heart meridian.

 

May Be Caused By:

 

Primary Causes

            General Body Qi Def - giving rise to HT deficiency

            Emotional Stress        - causes LV Qi Stag – impairs HT function

- causing LV Qi Stag – blood stag. – blocks HT meridian – impairs HT function

-dysfunction of SP – damp/phlegm blocks meridian – SP can’t produce blood to nourish HT

            Chronic Illness           -consumes HT Qi & Yin

 

Secondary Causes

            Chronic Bi Syndrome - pathogens follows meridian and enters HT

            Acute/Chronic Bleeding         - blood Def. – HT isn’t nourished

            Epidemic Febrile Disease      - Toxic heat – attacks HT

Chronic Cough/Asthma          -LU Qi/Yang Def. with Phlegm – creates HT Qi Def.

Differentiate Between:

            Running Piglet Syndrome          – feeling starts in L. Jiao and goes up to throat

                                                            - Kidney Disorder

 

 

Heart Qi Deficiency

            Heart can’t push blood and can’t nourish itself

Palpitations with shortness of breath, dizziness, fatigue, spontaneous sweat, agg. by activity and amel. By rest.

            T – pale                                                            P – thin, weak

Treatment:        Nourish heart Qi and nourish Yin

Formula            Wu Wei Zi Tang

 

Heart Yang Deficiency

Palpitations, aversion to cold, scanty urine, edema, cold symptoms, shortness of breath, dizziness, fatigue, spontaneous sweat

            T -                                                                   P – deep

Treatment:        Warm and Strengthen Heart Yang

Formula            Bao Yuan Tang

                        Ling Gui Zhu Gan Tang – induce diresis if edema

 

Heart Yin Deficiency

Palpitations induced by fear with insomnia, dysphoria, 5-centre heat sensation, fever, night sweat, yin def. symptoms

                        T – red, scanty dry coat                                    P – thin, rapid

Treatment:        Nourish heart Yin and calm heart to relieve palpitations

            Formula            Tian Wang Bu Xin Dan

 

Heart and Spleen Deficiency

Palpitations with shortness of breath, dizziness, insomnia, poor appetite, soft stools, pale face

            T – pale, puffy                                                  P – weak

Treatment:        Nourish heart & spleen

Formula            Gui Pi Tang

 

Heart Qi / Blood Deficiency

            Palpitations, shortness of breath, dizziness, short of breath, pale

            Treatment:        Nourish heart Qi & Blood

            Formula            Zhi Gan Cao Tang

 

Liver and Kidney Yin Deficiency

Palpitations with insomnia, 5-centre heat sensation, back/knee ache/weakness, dizziness, tinnitus, blurred vision, reproductive disorders, LV/KD Yin Def. Symptoms.

            T – red, thin coat                                              P – thin, rapid

Treatment:        Nourish Liver – Kidney & Heart to calm the mind

Formula            Yi Guan Jian  - nourish liver & kidney

                        + Suan Zao Ren Tang   - nourish heart

 

Spleen and Kidney Yang Deficiency

Palpitations with fatigue, tired, aversion to cold, cold limbs, cold body, poor appetite, soft stool, scanty urine

                        T – swollen, pale, white coat                P – deep, thin, retarded

            Treatment:        Warm Spleen and Kidney and Induce diresis to calm heart

            Formula            Li Zhong Tang + Zhen Wu Tang (induce diresis)

 

Heart and Gall Bladder Qi Deficiency

Palpitations with fear, timid person, lots of dreams, fearful of lights and sounds, poor appetite

            T - pale                                                            P – thin, wiry

Treatment:        Nourish Heart and Gall Bladder Qi to calm the mind

Formula            Ping Bu Zhen Xin Dan

                        Wen Dan Tang

 

Turbid Phlegm Stagnation

Palpitations due to poor diet or over thinking causing dysfunction of spleen, shortness of breath, fullness/distended chest, easily nausea, bloated, poor appetite, heavy feeling

            T – teeth marks, slippery/greasy coat                P – wiry, slippery

Treatment:        regulate Qi to transform phlegm

Formula            Dao Tan Tang

                        Wen Dan Tang (phlegm heat)

 

Blood Stasis

Palpitations with shortness of breath, dysphoria, fullness in chest, slight pain in

 head

                        T – purple veins under tongue                           P – irregular

            Treatment:        promote blood circulation, remove blood stasis

            Formula            Xue Fu Zhu Yu Tang

 

 

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