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Heart vessel obstruction
心脉痹阻 〔心脈痹阻〕xīn mài bì zǔ
Also heart blood stasis obstruction (心血瘀阻 xīn xuè yū zǔ), a term used when blood stasis figures prominently.
A disease pattern chiefly characterized by intermittent heart palpitation or fearful throbbing; oppression and pain in the chest; phlegm, blood stasis, qì depression, and/or signs.
Description: Heart palpitation or fearful throbbing; intermittent stifling oppression and pain in the heart and chest with pain stretching into the shoulder, back, and medial aspect of the arm.
- When blood stasis is prominent, the signs are stabbing pain, dull dark tongue with stasis speckles, and a pulse that is fine, rough, and possibly bound or intermittent.
- When phlegm turbidity is prominent, the signs are copious phlegm, generalized heaviness, slimy white tongue fur, and a pulse that is sunken and slippery.
- When cold is prominent, the signs are sudden bouts of heart pain arising on exposure to cold and relieved by warmth, fear of cold, cold limbs, a pale tongue with white fur, and a pulse that is sunken and either slow or tight.
- When qì depression is prominent, the signs are distension and pain in the heart and chest that occur in episodes brought on by emotional stimulus, pale tongue with thin white fur, and stringlike pulse.
Pathogenesis: This pattern arises in older, weaker patients, often after enduring illness, when right qì and devitalized heart yáng allow any of four factors to impede the flow of the blood in the heart vessels:
- blood stasis;
- phlegm turbidity;
- congealing yīn cold (externally contracted or cold arising from yáng vacuity);
- qì depression.
In clinical practice, simple blood stasis and yīn cold are commonly seen. However, since the factors are mutually conducive, two or more factors are often at play: qì stagnation and blood stasis; qì depression and congealing phlegm; qì depression, blood stasis, and congealing phlegm; congealing cold, qì depression, and blood stasis.
Analysis of signs: Heart vessel obstruction is marked by heart palpitation or fearful throbbing, stifling oppression and pain in the heart and chest, with pain stretching into the shoulder and medial aspect of the arm, occurring episodically. Depending on the factors at play, other signs vary:
- Blood stasis: Stabbing pain in the heart and chest; dark-purple tongue with purple speckles or macules; and a pulse that is fine and rough, and possibly interrupted (bound or intermittent).
- Phlegm turbidity: Oppression in the chest is pronounced and accompanied by obesity, a subjective feeling of generalized heaviness; a slimy white tongue fur; and a pulse that is sunken and slippery.
- Congealing cold: Sudden bouts of heart pain arising on exposure to cold and relieved by warmth, fear of cold, cold limbs, a pale tongue with white fur, and a pulse that is sunken and either slow or tight.
- Qì depression: Distension and pain in the heart and chest that occurs in episodes brought on by emotional stimulus; pale tongue with thin white fur; and a stringlike pulse.
Diseases: Heart palpitation; chest impediment; heart pain. Heart vessel obstruction is notably seen in myocardial infarction.
Treatment
Medicinal therapy: Warm yáng and boost qì; dispel phlegm and expel stasis. Use
Acumoxatherapy: Base treatment mainly on back transport points, CV, SP, and LR. Select
Further developments: Vacuity desertion of heart yáng, characterized by heart palpitation, stifling oppression in the heart and chest, cold sweating, reversal cold of the limbs, clouded spirit, and a faint pulse.
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