Heart Vessel obstructed

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At a glance

Key attributes

Chinese name: 心脉痹阻      Pinyin name: Xīn Mài Bì Zǔ

Pattern nature: Full combined pattern

Pattern(s) it combines from: Heart Blood Stagnation Heart Qi Stagnation Phlegm Cold

Causes

Precursor patterns: Qi Stagnation Yang Deficiency or Empty Yang

Common causes: 1. Emotional stress, 2. Diet, 3. Excessive physical work

Diagnosis

Common symptoms: Phlegm Depression Heart pain Chest pain Purple lips and ten other symptoms

Pulse type(s): Choppy (Se), Knotted (Jie), Slippery (Hua), Wiry (Xian)

Tongue description: Swollen tongue with a sticky coating.

Treatment

Treatment principle: Invigorate Heart Qi and Heart Blood, eliminate Stagnation, remove Phlegm, expel Cold, open the chest, calm the Mind.

Common formulas: Xue Fu Zhu Yu Tang Chai Hu Shu Gan San Di Tan Tang and one other formulas

Pathology

This is a complicated pattern as it is the combination of four other patterns and their features at the same time: Phlegm, Heart Blood Stagnation, Heart Qi Stagnation,  and Cold.  

If Phlegm is the dominant one out of the above four patterns, the pulse is rather Slippery instead of Wiry, Choppy or Knotted. Regardless the Phlegm in the Heart is of Hot or Cold nature, it can cause a swollen tongue, a feeling of chest oppression, feeling of heaviness, shortness of breath with inability to lie down, and spitting of phlegm. Di Tan Tang, together with Long-stamen onion builbs, Snake gourds and Crow-dipper rhizome, is more suitable for treatment if Phlegm is the main feature. 

Heart Blood Stagnation causes stabbing or pricking pain which comes and goes. This pain often occurs around the Heart or chest area but may also spread to the upper back or shoulder. In additional to that, the patients' lips, face, nail and tongue can turn to purple color due to the Stagnation of Heart Blood. Xue Fu Zhu Yu Tang is more recommended if these features are more obvious. 

Emotional symptoms such as mental restlessness or depression are caused by both Heart Qi and Blood Stagnation. Chai Hu Shu Gan San is recommended if Heart Qi Stagnation is more dominant. 

Finally, there are also Cold pattern features such as cold hands or feeling of cold. This Coldness  can congeal muscle and worsen chest pain discussed above. In this case, it is suggested to use Dang Gui Si Ni Tang together with Immature bitter orange, Long-stamen onion bulbs and Cinnamon twigs

Causes

Precursor patterns: Heart Vessel obstructed can derive from Qi Stagnation Yang Deficiency or Empty Yang

Emotional stress: Emotional stress such as worry, anxiety and anger can cause Heart Qi Stagnation and then Heart Blood Stagnation.

Diet: Excessive consumption of dairy foods and greasy foods accumulates Phlegm, which is one of the pathogenic factors in this pattern.

Excessive physical work : Excessive physical work can harm Heart and Kidney Yang, which then fail to move Blood and Qi in the chest. As a result, Heart Qi and Blood stagnate.

Diagnosing Heart Vessel obstructed

Pulse type(s): Choppy (Se), knotted (Jie), slippery (Hua) or wiry (Xian)

Tongue description: Swollen tongue with a sticky coating.

Main symptoms: Phlegm Depression Heart pain Chest pain Purple lips Purple face Palpitations Purple nails Restlnessness Frequent sighing Aversion to speak Shortness of breath Cold hands and feet Feeling of heaviness Feeling of oppression of the chest

Diagnosis commentary: Key characteristic symptom of this pattern is chest pain. Actually together with Heart Blood Stagnation, they are the only two Heart patterns that involves chest pain.

Treating Heart Vessel obstructed

Treatment principle

Invigorate Heart Qi and Heart Blood, eliminate Stagnation, remove Phlegm, expel Cold, open the chest, calm the Mind.

Herbal formulas used to treat Heart Vessel obstructed

Chai Hu Shu Gan San

Source date: 1602

Number of ingredients: 7 herbs

Key actions: Disperses Stagnant Liver Qi and Blood. Alleviates pain. Harmonizes Blood.

Formula summary

Chai Hu Shu Gan San is a 7-ingredient Chinese Medicine formula. Invented in 1602, it belongs to the category of formulas that promote Qi movement.

Besides Heart Vessel obstructed, Chai Hu Shu Gan San is also used to treat Rebellious Qi or Liver Blood Stagnation.

Read more about Chai Hu Shu Gan San

Xue Fu Zhu Yu Tang

Source date: 1830 AD

Number of ingredients: 11 herbs

Key actions: Invigorates the Blood. Dispels blood Stagnation. Spreads the Liver Qi. Unblocks the channels.

Formula summary

Xue Fu Zhu Yu Tang is a 11-ingredient Chinese Medicine formula. Invented in 1830 AD, it belongs to the category of formulas that invigorate Blood and dispel Blood Stagnation.

Besides Heart Vessel obstructed, Xue Fu Zhu Yu Tang is also used to treat Heart Blood Stagnation or Qi And Blood Stagnation.

Read more about Xue Fu Zhu Yu Tang

Di Tan Tang

Source date: 1470 AD

Number of ingredients: 9 herbs

Key actions: Removes Phlegm. Opens the sensory orifices. Tonifies Qi.

Formula summary

Di Tan Tang is a 9-ingredient Chinese Medicine formula. Invented in 1470 AD, it belongs to the category of formulas that dispel Phlegm.

Besides Heart Vessel obstructed, Di Tan Tang is also used to treat Phlegm Misting the Heart.

Read more about Di Tan Tang

Dang Gui Si Ni Tang

Source date: 220 AD

Number of ingredients: 7 herbs

Key actions: Warms the Channels. Disperses Cold. Nourishes the Blood. Unblocks the Blood vessels.

Formula summary

Dang Gui Si Ni Tang is a 7-ingredient Chinese Medicine formula. Invented in 220 AD, it belongs to the category of formulas that warm Interior Cold.

Read more about Dang Gui Si Ni Tang

Consequence patterns

Dryness

Blood Stagnation and Phlegm are the two patterns under this complex aggregated pattern. When Blood stagnates or Phlegm accumulates in the chest, it can cause Dryness in other part of the body.