Chest Impediment ( Xiong Bi) Flashcards
What is chest impediment?
 Obstruction of Qi and blood in the chest.
Always a combination of access and efficiency. Root is usually a deficiency of SP, HT or KD
Characterized by chest oppression that may radiate to left upper back, shoulder and down the arm + respiratory symptoms such as; SOB, dyspnea, orthopnea, Sharp crushing pain.
Symptoms depend on type of impediment.
Chest Impediment
GENERAL RED FLAGS
Two main diseases
⚡️sustained intense chest pain ( lasting 30 min or more), palpitations,fear, dread, breathless, vomiting, cold sweat
Example: MI
⚡️ Sudden onset SOB
⚡️tearing chest pain radiating to back
Features of shock!
Example: Pulmonary Embolism
Main western diseases in the Chest Impediment category ?
Pleurisy
Pulmonary Embolism
Carcinoma of bronchus
Angina pectoris
Myocardial infarction MI
Hiatal hernia
Carcinoma of esophagus
Red flag
PLEURISY
Inflammation of the pleura
•Stabbing pain bellow nipple
•worse on Inhalation  (very painful as pleura is rubbing against each other)
•shallow breathing
•Constricted chest
•Hemoptysis ( vomiting blood)
Like breathing in shards of glass
Reg flag
PULMONARY EMBOLISM
Embolus detaches from thrombus and occludes a lung artery
•Ranges from severe chest pain to shock!
•Sudden SOB, pallor, drop in BP
Red Flag
CARCINOMA OF THE BRONCHUS
Men +40
Malignancy
•fatigue
•weighloss
• Hemoptysis
•chronic
Red flag
ANGINA PECTORALIS
•goes away with rest! ( no like in MI)
• YANG XU Signs: Worse with exercise, cold, excitement, over acting
• Sudden bouts of Severe chest pain, may radiate, nausea, vomiting
Reg flags
MYOCARDIAL INFRACTION
Call 911
Blocked coronary artery decreases xue to HT and causes necrosis
• sudden severe, radiating chest pain at rest
Red flags
HIATAL HERNIA
Protrusion of upper part of ST through diaphragm into thoracic cavity
• Chest pain on sternum
• Nausea, belching, hiccups,regurgitation,dyspnea
Red flags
CARCINOMA OF ESOPHAGUS
Malignancy
• retrosternal pain on swallowing
• tiredness, weight loss, enlarged lymph
Etiology and pathogenesis of chest impediment
cold pathogens with pre-existing Yang xu
Explain how cold pathogens and pre-existing yang xu can cause chest inpediment?

Constrict vessels and blocks yang -
Blood stasis with sharp pain
Etiology of chest impediment
emotional stress
Explain how emotional stress causes chest impediment? 
Causes SP qi xu and LR qi xu -blood stasis with pain and distension
Etiology and pathogenesis of chest impediment
IMPROPER DIET
How does improper diet causes chest impediment ?
Greasy/raw foods hinders SP/ST-Slim blocks circulation of Qi and blood- Blood stasis
Etiology and pathogenesis of chest impediment
AGING/XU CONSTITUTION
How does aging and xu
Constitution cause chest impediment ?
Kd yin /yang xu- HT yin and xue xu or HT yang xu
Etiology and pathogenesis of chest impediment
EPI damp -heat invading
How does EPI damp heat invading cause chest impediment?
Fever, long-term heat damage (e.g rheumatic fever) damages yin and Yang 
7 Points
Points for Chest Impediment
Hint: Special Points
PC6- command point of chest
PC4- xi cleft of PC
action: acute chest pain / break blood stasis
HT6- xi cleft
action: acute pain/ move blood
empirical point to tonify HT YIN
CV14- front mu HT
CV17- Influetial point of qi ( great for qi xu)
BL14- Back shu PC
BL15- Back shu HT
4 Points
Points specific for
heart blood stasis
Fix, stabbing chest pain, more severe at night, palpitations, restless
MOVE XUE:
BL17- blood back shu
Sp10- sea of blood
MOVE QI: not for xu conditions
LR3 LI4
2 points
points specific for
phlegm stagnation
Oppressive pressure / pain w/ sense of suffocation, possible radiation
RESOLVE PHLEGM:
St40- empirical point phlegm
Sp9- empirical point damp
Name points specific for ** cold congealed in chest** to add to the main chest impediment points
Acute onset chest pain, radiating, aggravated by cold, SOB, palpitations, difficult respiration, pale complexion, cold limbs
DISPERSE COLD:
DU4- Ming man
CV4- Guan Yuan
REN8
Apply Moxa
Name points specific for Qi and Yin Xu to add to the main chest impediment points
Intermittent dull and oppressive chest pain, SOB, palpitations, worse with exertion, fatigue, dizziness, vertigo
TONIFY QI
CV6- qi hai
ST36- ZSL
NOURISH YIN, clean deficient heat:
KD6
LR3
SP6
Name points specific for Yang Qi exhaustion to add to the main chest impediment points
Chest oppression which with SOB, dull pain, aggravated with by cold, palpitations, sweating, fatigue, cold intolerance, pale complexion, cyanotic lips, nails, tongue
TONIFY YANG
REN4
DU4
What is the main difference between angina pectoralis and MI?
angina pectoralis gets better with rest worse with exertion
