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Tcm IntMed ChestPain

QuestionAnswer
In TCM what causes chest pain Heat scorching and knotting the chest, Phlegm obstruction, Qi stagnation, Cold congealing Heart Blood, Heart yang deficiency, Blood stagnation, Heart (Lung and Spleen) qi deficiency, Heart (and Kidney)yin deficiency
Stuffiness, generalised mild discomfort or fullness, which is aggravated by stress and emotional upset, and relieved by relaxation or sighing indicates Qi stagnation
Watery sputum or rattles in the chest, chest stuffiness or discomfort, which is worse on overcast or rainy days, and a greasy coat on the tongue indicates Accumulation of phlegm
Mild pain and stuffiness, brought on by activity and accompanied by shortness of breath, palpitations or flutters Heart qi deficiency
Burning pain. Mostly due to some Hot pathogen. If accompanied by irritability, restlessness, a red tongue with a yellow coat and a rapid pulse without obvious signs of deficiency pathogenic Heat or Fire penetrating into the Heart.
Stuffiness in the chest, paroxysmal burning pain, expectoration of thick sputum and a greasy yellow tongue coat Phlegm heat or fire
Burning pain with palpitations, dizziness and a red, dry tongue with little or no coat Deficient fire from yin deficiency
A sharp or stabbing pain, which is fixed in location, accompanied by a purple tongue indicates Stagnant blood
Sharp pain may also be due to focal disorders of the chest wall, in which case it is usually aggravated by Deep breathing or coughing
Crushing, squeezing, twisting pain • Feels like the Heart is being squeezed and crushed in a vice, or a weight is squashing the chest. Often accompanied by cold limbs, aversion to cold, and signs of yang deficiency. Mostly due to accumulation of yin Cold as a result of yang deficiency or invasion by external Cold.
burning, sharp, focal or retrosternal chest pain aggravated by cough, deep breathing, movement, exertion and swallowing • fever • irritability • dry mouth and thirst • rough laboured breathing • cough with thick yellow mucus • constipatio Heat scorching and knotting the chest
Treatment principle for chest pain due to Heat scorching and knotting the chest Clear heat purge fire. Invigorate blood, disperse accumulation
Point Rx for chest pain due to Heat scorching and knotting the chest for external Heat use LI.11 (qu chi-), Bl.13 (jei shu-), Lu.S (chi ze -), PC.8 (lao gong-), Bl.15 (xin shu-), Du.14 (da zhui-), PC.3 (qu ze !), Ren.17 (shan iftong -) • for Liver Heat use PC.S (;'ian sht), PC.6 (nei guan), Bl.18
mild stuffiness, discomfort or tightness in the chest which is aggravated during wet or cold weather • cough with thin watery sputum • nausea and poor appetite •lethargy • loose stools T pale with a greasy white coat P slippery Phlegm fluids
suffocating, tight or oppressive sensation in the chest, or chest pain radiating to the shoulders or upper back, aggravated during cloudy or rainy weather • tendency to obesity • feeling of heaviness in the body • dizziness • wheezing with thic Turbid phlegm
suffocating, tight, oppressive burning sensation or pain in the chest • thick yellow sputum • bitter taste in the mouth • thirst • irritability and resdessness, possible clouding of consciousness • dry stools or constipation T greasy yellow Phlegm heat (fire)
Wind phlegm
Treatment principle for chest pain due to phlegm
Points Rx for phlegm St.40 (jeng long-), Ren.17 (shan zhong -), PC.6 (nei guan), PC.S (jian shz), PC.4 (xi men-), Bl.13 (jei shu), Bl.15 (xin shu), Bl.14 (jue yin shu) • with Phlegm Fluids add Lu.7 (lie que) and moxa to points on the trunk • with Turbi
Liver qi stagnation
Treatment principle for chest pain due to liver qi stagnation mild, recurrent fullness, stuffiness, tightness or pain in the chest that is not localised, is provoked by emotional turmoil and relieved by sighing, belching and relaxation • frequent sighing • the patient may appear uptight, anxious, nervy or
Point Rx for chest pain due to liver qi stagnation
severe crushing or constricting retrosternal chest pain, which may be initiated or aggravated by cold weather or cold foods; the pain may radiate to the neck, jaw, left arm or through to the back • shortness of breath, dyspnoea or orthopnoea • pal Cold congealing heart blood circulation
Treatment principle for chest pain due to cold congealing heart blood circulation
Point Rx for chest pain due to cold congealing heart blood circulation Bl.15 (xin shu +A), Bl.14 (jueyin shu +A), Ren.17 (shan zhong +A), Ren.15 (jiu wei +A), Du.14 (da zhui +A), St.36 (zu san li +A), PC.6 (neiguan -), PC.4 (xi men-) • treatment may be given frequently, every few hours in manageable ca
suffocating, tight or dull chest pain, or stuffiness in the chest, which is provoked or aggravated by exertion and exposure to cold • shortness of breath with exertion, in severe cases (with pulmonary oedema) wheezing or orthopnoea • cold intolerance Heart yang deficiency
Treatment principle for chest pain due to heart yang deficiency Warm and tonify yang. Warm and invigorate heart yang
Acu point Rx for chest pain due to heart yang deficiency Bl.15 (xin sh11 .A.), Bl.14 (j11eyin sh11 .A.), Bl.23 (shen sh11 .A.), Ren.6 (qi hai .A.), Ren.4 (g11any11an .A.)Ht.7 (shen men), PC.6 (neigt~an), Ren.9 (sh11ijen .A.), St.36 (ZN san lz), Sp.6 (sanyinjiao)
relatively chronic and severe chest pain, which is stabbing or crushing, fixed in location and usually worse at night or with sudden excitement, anger, emotion or exertion • palpitations, or sensations of the heart skipping beats during an attack • Blood stagnation
Treatment principle for chest pain due to blood stagnation Invigorate blood and eliminate blood stasis. Open the heart vessels and stop pain
Acu points Rx for chest pain due to blood stagnation Bl.15 (xin shu-), Bl.14 (jueyin shu-), Bl.17 (ge shu-), Bl.13 (jei shu), hua tuojiaji (M-BW-35)- from T3-T7 depending on tenderness, PC.6 (nei guan -), PC.4 (xi men -), Ren.17 (shan zhon~, Du.12 (shen zhu), Du.10 (ling tat), Sp.10 (xue
mild, dull, intermittent chest pain • stuffiness in the chest • shortness of breath or dyspnoea with exertion • palpitations with anxiety • fatigue and weakness o easily flustered and panicky • low voice or reluctance to speak • pale or sal Heart (lung and spleen) qi deficiency
Treatment principle for chest pain due to heart (lung and spleen) qi deficiency Tonify the heart qi, invigorate yang qi in the chest
Acu point Rx for heart(lung and spleen) qi deficiency Sp.6 (sanyinjiao +), Ht.7 (shen men+), PC.6 (neiguan), Lu.7 (lie que), Ren.17 (shan zhon~, BL15 (xin shu+), BL17 (ge shu), Bl.20 (pi shu+), St36 (i!J san li +) • with insomnia add an mian (N-HN-54)
Heart (and kidney) yin deficiency
Treatment principle for chest pain due to heart (and kidney) yin deficiency Nourish heart yin and calm the shen. Regulate blood, clear heat
Point Rx for chest pain due to heart (and kidney) yin deficiency Bl.15 (xin shu+), Bl.14 (jueyin shu+), Bl.23 (shen shu+), Kid.3 (tai xi+), Ht.7 (shen men), Ht.S (tong lz), PC.6 (neiguan), Ren.17 (shan zhon!), yin tang (M-HN-3), Lu.7 (lie que), Kid.6 (zhao haz)
suffocating, tight sensation in the chest with occasional pain • stiffness or retraction of the tongue • speech impairment • hemiplegia • dizziness • numbness and spasm in the limbs T greasy coat P wiry and slippery
Open and unblock chest yang + warm and transform Phlegm Fluids + transform Turbid Phlegm + transform Phlegm and clear Heat (Fire) + extinguish Wind and transform Phlegm
Liv.14 (qi men), Liv.3 (tai chong-), PC.6 (nei guan), PC.S (jian shz), Bl.18 (gan shu), Ren.17 (shan zhon!), Lu.7 (lie que),yin tang (M-HN-3) • with Heat add Liv.2 (xingjian -) • with deficiency add St.36 (zu san li +), Sp.6 (s
Warm and disperse Cold, invigorate Blood Remove obstruction and promote circulation of Heartyang
intermittent, relatively mild chest pain, which may be burning or suffocating • fullness and discomfort in the chest • palpitations with anxiety • resdessness, irritability and insomnia • night sweats • facial or malar flushing • dry mouth
mild, recurrent fullness, stuffiness, tightness or pain in the chest that is not localised, is provoked by emotional turmoil and relieved by sighing, belching and relaxation• frequent sighing• the patient may appear uptight, anxious, nervy or de
Created by: Jkellycal