TCM and Heart Diseases
Chinese Medicine (TCM) Diagnosis of Heart Disease
In Chinese medicine, chest pain and heart failure have many different causes. The basic cause of chest pain is obstruction of the circulation of Qi and blood. Chest pain may be caused by either deficiency or excess patterns. Deficient patterns include weak circulation of blood with pooling of blood causing stickiness or increased viscosity of the blood (yin deficiency) which causes stagnation of both Qi and blood. Excess patterns include pathogenic substances which block the circulation of Qi and blood. Generally heart failure is a complex disorder which combines both excess patterns with underlying deficiency patterns (root and branch).
Kidney Yang, Heart Yang, and Lung Yang deficiency are the most prominent patters which may result in water retention and/or Blood Stasis.
Kidney and Heart control whole body Yang
Right foot edema – Yang Qi disorders
Left foot edema – Yin disorders
Chinese Medicine Heart Pain Patterns
Heart Yang Deficiency
Yang deficiency is the root of many chest pain patterns that involve the heart, especially those which are due to deficiency cold and phlegm obstruction. With yang deficiency there is accumulation of cold, the heart is weakened therefore circulation is impaired and fluids are failed to be transformed accumulating into phlegm and dampness.
Clinical symptoms of yang deficiency are chest pain as if heart is being squeezed and crushed, cold limbs, aversion to cold and other yang deficiency symptoms.
Heart Qi Deficiency
Similarly to yang deficiency, heart Qi deficiency will manifest similar symptoms with less cold and milder pain. Heart Qi deficiency has a weakened heart and poor circulation therefore Qi and blood stagnation and fluids are not transformed properly giving rise to phlegm and dampness.
Clinical symptoms of Qi deficiency are mild pain in chest, stuffiness in chest, shortness of breath, all symptoms aggravated by physical activity, palpitations and flutters.
Heart Qi and Blood Deficiency
General overwork and excessive worry or mental activity, irregular dietary habits, excessive consumption of cold, raw foods or prolonged illness can weaken the spleen Qi and there fore it’s blood production giving rise to Qi and blood deficiency and heart disease. When Qi is weakened it is unable to circulate properly in the body giving rise to stagnation of either Qi or blood or both and phlegm accumulation due to the weakened spleen function.
Clinical symptoms of Qi and blood deficiency are mild pain in chest, stuffiness in chest, shortness of breath, all symptoms aggravated by physical activity, palpitations and flutters (same as heart Qi deficiency) with paleness of face, tongue and eye lids as well as difficulty falling asleep.
Heart and Kidney Yin Deficiency
Kidney yin will become damaged through overwork, late nights, inadequate sleep, excess sexual behaviour, drug use, pregnancy, febrile illness and in general aging. Heart yin will be damaged through emotional trauma, shock, ongoing anxiety and excessive worry. When the kidney yin is weak it is unable to support the heart yin and they become unbalanced and blood circulation begins to stagnate due to increased blood viscosity. The deficiency yin heat then congeals fluids into phlegm creating both blood and phlegm stagnation.
Clinical symptoms of kidney and heart yin deficiency are burning pains with palpitations, dizziness, red/dry tongue with no coat, 5 heat sensation, insomnia and possible eye disorders.
Heart Blood Stagnation
Blood stagnation causing heart disease is usually the end result of other prolonged illness’s effecting the upper jiao area. Generally, any pathology excess or deficient if chronic may lead to blood stagnation.
Clinical symptoms of blood stagnation are palpitations, oppression in the chest, periodic chest pain, purplish discoloration of the lips and nails with a dark purple tongue and a rough thready or intermittent pulse.
Phlegm Fluid Stagnation
Phlegm is a frequently implicated pathogen in chest pain and heart failure mainly due to a poor diet or liver qi stagnation overacting on the spleen.
Clinical symptoms of phlegm are watery sputum, rattling sputum in chest, stuffiness in chest, distention of chest worse on overcast or rainy days, greasy tongue coat.
Liver Qi Stagnation
General emotional imbalances can cause the movement of Qi in different organs to not circulate effectively leading to Qi and possibly blood stagnation. The liver meridian traverses the chest and is most notably effected by stress, anger and any other emotional upsets. These upsets can cause the liver to cause disharmony not only with itself but also with the heart and lungs.
Clinical symptoms of Liver Qi stagnation are mild recurrent fullness/stuffiness or tightness of the chest that is not localized to one particular area. The patient will sigh frequently, appear uptight, anxious or depressed and possibly experience dizziness and hyperventilation. The pulse will be wiry and the tongue may not have any significant characteristics.