Chest Bi Flashcards
Syndromes
Excess:
Heart Blood Stag
Retention of Turbid Phlegm in the Chest
Stagnation of Cold in the Chest
Def. (Remission)
Heart and Kidney Yin Def
Qi and Yin Def
Yang Qi Def - Mixed
Etiology
All block Cardiac Vessels
Invasion of Wind/cold/Damp -> Qi Stag and Blood Stasis
Emotional Frustration -> Liv: Qi Stag
-> Sp: Phlegm Damp
Irregular Diet - > Spleen Phlegm Damp
Phlegm Damp Constitution -> Phlegm Damp –> Phlegm Heat
Elderly -> Heart/Kid Yin Def. –> Flare up of Heart Fire –> Phlegm Heat
-> Kid Yang Def –> Heart Yang Def –> Blood Stasis
Interior Cold
Retention of Water
Fixed stabbing pain in the chest thats worse at night, pain may radiate to the shoulder, upper back or left arm, suffocation in chest
Heart Blood Stagnation
Sudden Attack of Severe pain thats relieved by warmth and aggravated by cold, chills and cold in limbs, palpations, pale complexion
Stagnation of Cold in the Chest
Oppression and intermittent pain in the chest, SOB, palpitations, lumbar soreness, chills, cold limbs, Edema, pale complexion and lips
Yang Qi Def
Suffocation and pain in chest, SOB with large amount of sputum, nausea, cough, asthma, overweight, heaviness of body, likes to eat oily/greasy foods
Retention of Turbid Phlegm in the Chest
Oppression and intermittent pain in the chest, dizziness, tinnitus, dry throat, 5 palm heat, insomnia, restlessness, palpitations, lumbar soreness
Heart and Kidney Yin Def
Oppression and pain in chest, palpitations, SOB, dizziness, fatigue, insomnia, sallow complexion
Qi and Yin Def
Retention of Turbid Phlegm in the Chest T and P
T: Thick, sticky and turbid
P: Soft and Moderate
Retention of Turbid Phlegm in the Chest POT
Disperse obstruction of chest yang
Promote circulation of Qi to expel phlegm
Retention of Turbid Phlegm in the Chest Points
St 40
Sp 9
Gb 34
Heart Blood Stag T and P
T: Dark purple with ecchymoses
P: Wiry, choppy or intermittent
Heart and Blood Stag POT
Quicken Qi and Blood to remove Blood stasis
Heart Blood Stag Points
Liv 3
Li 4
Sp 10
UB 17
Stagnation of Cold in the Chest T and P
T: White and slippery or white and sticky
P: Deep and slow
Stagnation of Cold in the Chest POT
Circulate the chest yang
Dissipate pathogenic cold
Stagnation of Cold in the Chest Points
Moxa at Ren 17
Pc 8
K 1
Chest Bi Basic Points
Ren 14/17 or UB 14/15
Pc 4/6
Hrt 6/7
Heart and Kidney Yin Def. T and P
T: Red or dark purple
P: Thready and wiry or thready and rapid
Heart and Kidney Yin Def. POT
Nourish Yin
Move Blood
Calm the mind
Heart and Kidney Yin Def. Points
K 6 or Sp 6
Qi and Yin Def. T and P
T: Tender red
P: Thready or knotted
Qi and Yin def. POT
Tonify Qi and Blood
Move Blood in the collaterals
Qi and Yin Def. Points
St 36 or Ren 6
K 6 or Sp 6
Yang Qi Def T and P
T: Dark purple with white tongue coating
P: Deep thready or intermittent
Yang Qi Def POT
Tonify Qi
Warm yang
Move blood in the collaterols
Yang Qi Def Points
Du 4
Ren 4-8
Moxa
Tests
EKG - Needs to be happening during an attack
Q and R base line will be raised indicating a heartattack
Main Organ and Correlating Organs
Main Organ: Heart
Related to: Liver, Spleen, Stomach, Kidney,Lung(Pulmonary Circulation)
Corresponding Western Diseases
Coronary Heart Disease
Angina
Heart Attack
Main Symptoms
Chest pain: crushing pain deep inside with emotional pain
Fatigue
Radiating pain to left arm/shoulder/neck/upper back(PC/Hrt Meridian)
Palpitations
Edema- Heart/Kid yang Def fail to heat water and water retention forms
Cough/dyspnea
Knotted/Intermittent pulse - Heart yang Def. not moving blood properly
Chief Pathology
Root Deficient - Heart yin and Heart Yang, sometimes kidney
Branch Excess- Phlegm, blood stasis, Qi stag, cold damp (Xie Qi)
Disease Differentiation
- Chest pain L or R *
1. Chest Bi Vs. Stomachache
Chest-Sternal LOCATION Epigastric Region
Heart Disease/High BP MEDICAL HISTORY Digestive symps
Palpitation,knotted pulse ASSC. SYMPTOMS Diarrhea/Constipation
- If patient complains of chest pain or stomachache palpate for tender spots and get them to show you the exact area of pain. ALWAYS MISDIAGNOSED!
2. Chest Bi Vs. PleurisyPAINFUL BREATHING
- Chest Bi Vs. PalpitationsChest pain CHIEF COMPLAINT Palpitations
Pattern Differentiation
In acute stage separate the Biao and Ben
ie. severe pain alleviated by warmth, aggravated by cold
POT
Look at Biao and Ben
During attack Biao is dominate - if phlegm transform phlegm etc.
In Remission its Ben
Tx
- Basic Points: Ren 14/17 or UB 14/15 - Front mu/Back shu combo
Pc 4/6
Hrt 6/7 - Moxa Ren 17 to warm chest yang, Pc 6, UB 14/15, St 36
Choose 2-3 pts for 20 min - Jiaji T4-T5 - Around heart and Pc back shu
- Palpate Backshu/Du points on upper back for tender spots or places of color changes and needle those reactive spots
- Palpate around Kid 22 on the left and needle tender pts
- Auricular: Hrt, Sm Int, Shenmen, Sub Cortex, Sympathtic, Kid, Liv
spleen, Chest, endocrine
3-4 points and leave for 3-5 days, AVOID lots of stimulation with seeds
7: Herbal: Garlic for warming yang and opening chest
She Xiang Bao Xin Wan - During attack
Main types of points to needle
Front Mu
Back Shu
Yuan Source
XiCleft
Acute Chest Pain Points
Pc 6 and Hrt 5
Will cause a conduction of Qi to the heart and symptoms will be greatly relieved
- Hard to send Qi up the body but if you do there will be a huge difference
- Needling pain shouldn’t last more than 2 days if its a healing crisis
Education
Keep Warm - prevent EPF especially in the winter
Regulate Emotion - Worry, joy, anger
Reg Diet - Don’t overeat, avoid damp greasy food
No Smoking
Avoid Overwork/Overthinking
Moderate Alcohol intake - some alcohol is good :)
Seniors - Moderate exercise like Qi Gong/Tai Chi to increase
heart muscle strength and increase circulation
Random Info
- Weather affects the heart especially cold so winter is the worst
- Exercise helps move Qi and Blood causing a decrease in Stagnation
- Overweight people are more of a phlegm constitution, shiny/oily skin
- Invisible phlegm - cholesterol
- Sore throat in the elderly can be an initial sign of a heartattack!
Differentiation of a mild or severe heart attack
Mild:
Chest Tightness
Pain
Palpitation
Severe: Pain Increased - shooting to arm and neck Can't sleep Cold Sweating Cold Limbs Purple lips/hands
Def
Partial Blockage of the Cardiac Vessels - Myocardial Infarction
- Medical History Important!
- Nitroglycerin
- Will usually die within 30 min
