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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.

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:

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:

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 Peach Kernel and Carthamus Brew (桃仁红花煎 táo rén hóng huā jiān), House of Blood Stasis-Expelling Decoction (血府逐瘀汤 xuè fǔ zhú yū tāng), or Trichosanthes, Long-Stamen Onion, and White Wine Decoction (栝楼薤白白酒汤 guā lóu xiè bái bái jiǔ tāng).

Acumoxatherapy: Base treatment mainly on back transport points, CV, SP, and LR. Select BL-15 (Heart Transport, 心俞 xīn shù), BL-17 (Diaphragm Transport, 膈俞 gé shù), CV-14 (Great Tower Gate, 巨阙 jù què), CV-17 (Chest Center, 膻中 shān zhōng), PC-6 (Inner Pass, 内关 nèi guān), SP-10 (Sea of Blood, 血海 xuè hǎi), SP-6 (Three Yīn Intersection, 三阴交 sān yīn jiāo), and LR-3 (Supreme Surge, 太冲 tài chōng); needle with drainage and add moxa.

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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