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Tcm IntMed ChestPain
| Question | Answer |
|---|---|
| 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 â¢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 |