Dilated Cardiomyopathy
Dilated cardiomyopathy is a type of cardiomyopathy characterized by enlargement of the left or both ventricles accompanied by systolic dysfunction. It is often associated with heart failure and arrhythmias and has a very high mortality rate. It is characterized by myocardial degeneration, necrosis, and fibrosis, leading to impaired systolic pumping function, cardiac enlargement, and congestive heart failure. It is a primary cardiomyopathy. Other primary cardiomyopathies include hypertrophic cardiomyopathy, restrictive cardiomyopathy, arrhythmogenic right ventricular cardiomyopathy, and unclassified cardiomyopathy.
TCM Pattern Differentiation and Medication Reference
| Common Symptoms
Clinical Description:
Restlessness and palpitations, chest oppression with dull pain, a dry, red, sore throat, vexing heat in the palms, soles, and chest or a low-grade fever, and thirst without desire to drink. The tongue is red with scant coating or a yellow coating; the pulse is thready and rapid, or irregular with pauses.
In Plain Language:
- Feeling restless and aware of an uneasy or fluttering heartbeat.
- A feeling of tightness in the chest with mild, vague pain.
- A dry, red, sore throat.
- Heat in the palms, soles, and chest, with internal restlessness or a low-grade fever.
- Feeling thirsty but not wanting to drink much water.
- The tongue appears reddish, with little coating or a yellow coating.
- The pulse feels thready and rapid, or has irregular pauses.
| Treatment Approach
Clinical Description:
Clear heat and nourish Yin; protect the heart and cool the blood.
In Plain Language:
- In TCM theory, clearing internal heat and nourishing Yin fluids is intended to help balance excess heart fire and insufficient fluids, potentially easing restlessness, thirst, afternoon heat, night sweats, and a dry throat or mouth.
- Cooling the blood and supporting the heart, while calming the mind, is intended to ease palpitations, restlessness, irritability, facial flushing, a bitter taste in the mouth, and disturbed sleep with vivid dreams.
| Related Products
The products below are provided for informational reference only and do not constitute medical advice or a prescription. Follow the product packaging and instructions, and use under the guidance of a doctor or pharmacist.
| Common Symptoms
Clinical Description:
Palpitations and being easily startled, chest oppression and shortness of breath, palpitations on exertion, a restless mind, and intermittent low-grade fever. The tongue is pale with a white, greasy coating; the pulse is soft or irregular with pauses.
In Plain Language:
- Feeling the heart race or flutter, being easily startled, and feeling unsettled.
- A feeling of tightness in the chest, with breathing that feels restricted or uncomfortable.
- Palpitations become more noticeable and uncomfortable with activity or exertion.
- Feeling uneasy and tense, and finding it hard to relax even when sitting quietly.
- Intermittent episodes of low-grade fever that come and go.
- The tongue appears pale rather than rosy.
- The tongue coating is white and greasy, and the tongue surface looks moist and slippery.
- The pulse feels soft and weak, or has irregular pauses.
| Treatment Approach
Clinical Description:
Tonify qi and nourish the heart; transform dampness and clear pathogenic toxins.
In Plain Language:
- In TCM theory, strengthening qi and nourishing the heart is intended to support the heart and may ease shortness of breath, fatigue, palpitations, restlessness, insomnia, and vivid dreams.
- Transforming dampness and clearing pathogenic toxins is intended to ease epigastric fullness, a sticky feeling in the mouth, tiredness, and dampness-related symptoms such as a sore throat or skin redness and swelling.
| Related Products
The products below are provided for informational reference only and do not constitute medical advice or a prescription. Follow the product packaging and instructions, and use under the guidance of a doctor or pharmacist.
| Common Symptoms
Clinical Description:
Palpitations, restlessness, insomnia, soreness and weakness in the lower back and knees, nocturnal emission, and tinnitus. The tongue is red with scant coating; the pulse is thready and rapid.
In Plain Language:
- Feeling palpitations or an uneasy heartbeat, sometimes with a startled or unsettled feeling.
- Feeling restless and having difficulty falling asleep or staying asleep; sleep may feel disturbed.
- Soreness and weakness in the lower back and knees, which may be more noticeable after standing or walking for a long time.
- Involuntary ejaculation during sleep, often associated with dreams.
- A buzzing or ringing sound in the ears, which may be noticeable even in quiet surroundings.
- The tongue appears reddish and has little coating, giving it a relatively smooth appearance.
- The pulse feels thready and rapid, with a faster rate and relatively weak force.
| Treatment Approach
Clinical Description:
Tonify the kidneys and nourish the heart; harmonize the heart and kidneys.
In Plain Language:
- In TCM theory, supporting kidney qi and nourishing heart Yin is intended to help ease soreness and weakness in the lower back and knees, aversion to cold, fatigue, palpitations, and shortness of breath.
- Harmonizing the heart and kidneys is intended to ease restlessness, being easily startled, insomnia, vivid dreams, and excessive worry, helping promote a calmer mood and more settled sleep.
| Related Products
The products below are provided for informational reference only and do not constitute medical advice or a prescription. Follow the product packaging and instructions, and use under the guidance of a doctor or pharmacist.
| Common Symptoms
Clinical Description:
Palpitations, chest oppression or pain, fixed stabbing pain, shortness of breath that worsens with exertion, fatigue and weakness, low energy and reluctance to speak, a dull complexion, and bluish-purple lips and nails. The tongue is pale or dark purple, sometimes with teeth marks along the edges; the coating is thin and white; the pulse is thready and choppy.
In Plain Language:
- Feeling palpitations or an unsettled heartbeat.
- A feeling of tightness or pain in the chest, with discomfort when breathing.
- Sharp, stabbing pain, like being pricked by a needle.
- The pain tends to stay in one place rather than move around.
- Shortness of breath, which may be more noticeable when speaking or being active.
- The above symptoms become noticeably worse after activity or exertion.
- Feeling easily tired and weak, with energy quickly running out during tasks.
- Speaking in a low, weak voice, feeling short of breath and reluctant to talk much.
- The complexion appears dull and lacks a healthy glow.
- The lips and nails look bluish or purplish, with a dark, dull color.
- The tongue appears pale or dark purple rather than bright red.
- The tongue coating is thin and white.
- The pulse feels thready and rough, with an uneven flow.
| Treatment Approach
Clinical Description:
Tonify qi and invigorate blood; regulate qi and unblock the vessels.
In Plain Language:
- In TCM theory, supplementing qi and promoting blood circulation is intended to support blood flow and metabolism, potentially easing shortness of breath, fatigue, a dull complexion, spontaneous sweating, and easy tiredness.
- Regulating qi and unblocking the channels is intended to promote smoother blood flow and ease discomfort associated with qi stagnation and blood stasis, such as chest tightness, distending pain, stabbing pain, numbness, and cold limbs.
| Related Products
The products below are provided for informational reference only and do not constitute medical advice or a prescription. Follow the product packaging and instructions, and use under the guidance of a doctor or pharmacist.
| Common Symptoms
Clinical Description:
Palpitations and shortness of breath, fatigue and weakness, shortness of breath and reluctance to speak, dry throat and mouth, thirst, flushed cheeks in the afternoon, scanty urine, hard stools, dry mouth, and dry eyes. The tongue is red or dark purple, with purple spots or patches of blood stasis; the coating is thin and white or scanty; the pulse is soft and weak or irregular with pauses.
In Plain Language:
- Feeling palpitations or an unsettled heartbeat, together with shortness of breath.
- Feeling mentally and physically tired, with energy quickly running out during tasks.
- Shortness of breath and reluctance to talk much; speaking a few sentences may feel tiring.
- Dryness and discomfort in the throat, along with a dry mouth.
- Noticeable thirst and a desire to drink water, often needing to drink proactively.
- The cheeks may become flushed from afternoon to evening, with a sensation of warmth.
- Passing small amounts of urine infrequently, with difficulty or discomfort urinating.
- Hard, dry stools that are difficult to pass, with straining and infrequent bowel movements.
- A dry mouth and dry, gritty-feeling eyes.
- The tongue appears red or dark purple.
- Purple spots or bruise-like patches may be visible on the tongue.
- The tongue coating is thin and white, or barely visible.
- The pulse feels thready and soft, or has irregular pauses.
| Treatment Approach
Clinical Description:
Tonify qi and nourish Yin; unblock the vessels and calm the heart.
In Plain Language:
- In TCM theory, supplementing qi and nourishing fluids is intended to support energy and may ease dry mouth and throat, afternoon heat, night sweats, and restlessness with a tendency to feel hot.
- Unblocking the blood vessels and calming the mind is intended to ease discomfort associated with impaired circulation, such as chest tightness, stabbing pain, palpitations, and numbness in the limbs, and may help promote a calmer mood and more settled sleep.
| Related Products
The products below are provided for informational reference only and do not constitute medical advice or a prescription. Follow the product packaging and instructions, and use under the guidance of a doctor or pharmacist.
| Common Symptoms
Clinical Description:
Palpitations, aversion to cold and cold limbs, difficulty urinating, swelling of the limbs, soreness and coldness in the lower back and knees, fatigue and weakness, bluish lips, and a dark tongue. The coating is thin and white or white and slippery; the pulse is deep and thready or deep and weak.
In Plain Language:
- Feeling palpitations or an uneasy heartbeat, sometimes with a startled or unsettled feeling.
- Feeling easily chilled, with cold hands and feet, especially in cold weather.
- Difficulty passing urine or a weak urinary stream.
- Swelling in the limbs, with a feeling of fullness and heaviness.
- Soreness and a cold sensation in the lower back and knees, with greater discomfort after sitting or standing for a long time.
- Feeling tired and weak, with energy and motivation quickly fading during tasks.
- The lips appear bluish and the tongue looks dark rather than rosy.
- The tongue coating is thin and white, or looks white and slippery.
- The pulse feels deep and thready, or deep and weak.
| Treatment Approach
Clinical Description:
Warm Yang and tonify qi; promote urination and relieve wheezing.
In Plain Language:
- In TCM theory, warming Yang and supporting qi is intended to strengthen functional activity and may ease aversion to cold, cold hands and feet, shortness of breath, and fatigue.
- Promoting urination and resolving dampness is intended to support fluid elimination and ease chest tightness, shortness of breath, cough, wheezing, phlegm, difficulty urinating, or swelling, potentially making breathing feel easier.
| Related Products
The products below are provided for informational reference only and do not constitute medical advice or a prescription. Follow the product packaging and instructions, and use under the guidance of a doctor or pharmacist.
| Common Symptoms
Clinical Description:
Palpitations, chest oppression or pain, copious phlegm, or phlegm containing dark purple blood clots, scanty urine, lower-limb swelling, distended jugular veins, and a mass below the right rib cage. The tongue is purple with a white, slippery, greasy coating; the pulse is wiry and slippery or irregular.
In Plain Language:
- Feeling palpitations or an unsettled heartbeat, sometimes with a fluttering sensation in the chest.
- A feeling of tightness or discomfort in the chest, or intermittent stabbing pain.
- A noticeable increase in phlegm, with frequent coughing up of substantial amounts.
- Sometimes the phlegm contains dark purple or blackish blood clots.
- Passing small amounts of urine, with fewer trips to urinate and difficulty emptying the bladder.
- Swelling in the lower limbs, with a feeling of fullness and heaviness that makes walking more tiring.
- The surface veins in the neck appear prominently distended.
- A lump or sense of fullness may be felt below the right ribs, causing local discomfort.
- The tongue appears purple and dark rather than rosy.
- The tongue coating is white, slippery, and greasy.
- The pulse feels wiry and smooth, or has irregular pauses.
| Treatment Approach
Clinical Description:
Transform phlegm, dispel blood stasis, and promote urination.
In Plain Language:
- In TCM theory, resolving thick phlegm and promoting blood circulation is intended to address obstruction and may ease chest tightness, excessive phlegm, a heavy or drowsy feeling, stabbing pain, and numbness associated with phlegm and blood stasis.
- Promoting urination and resolving dampness is intended to support fluid metabolism and elimination, potentially easing swelling, lower-limb edema, and difficulty urinating, as well as chest tightness, shortness of breath, and heaviness or fatigue.
| Related Products
The products below are provided for informational reference only and do not constitute medical advice or a prescription. Follow the product packaging and instructions, and use under the guidance of a doctor or pharmacist.
| Common Symptoms
Clinical Description:
Palpitations and shortness of breath, worse with exertion, aversion to cold and cold limbs, swelling of the limbs, fullness in the flanks or epigastric oppression, vomiting of clear fluid, difficulty urinating, abdominal distension, and loose stools. The tongue is pale and enlarged, with teeth marks along the edges and a thin, white coating; the pulse is deep, thready, and rapid, weak under heavy pressure, or deficient and large with irregular pauses.
In Plain Language:
- Feeling palpitations and shortness of breath, as if there is not enough air.
- The symptoms become noticeably worse with activity or exertion.
- Feeling cold, with cold hands and feet, especially in cold weather.
- Swelling in the limbs, with a feeling of fullness and heaviness.
- A feeling of fullness and pressure in the flanks.
- A feeling of tightness and discomfort in the upper abdomen, as if it were blocked.
- Vomiting clear, watery fluid.
- Difficulty urinating or a weak urinary stream.
- Abdominal fullness and discomfort, with loose stools or diarrhea.
- The tongue looks pale and somewhat enlarged.
- Tooth marks may be visible along the edges of the tongue.
- The tongue coating is thin and white.
- The pulse feels deep, thready, and relatively rapid.
- The pulse feels weak when pressed firmly.
- Alternatively, the pulse may feel large but weak, with irregular pauses.
| Treatment Approach
Clinical Description:
Warm Yang and promote urination; transform phlegm and relieve wheezing.
In Plain Language:
- In TCM theory, warming Yang and promoting urination is intended to support functional activity and fluid metabolism, potentially easing aversion to cold, cold hands and feet, swelling, and difficulty urinating.
- Transforming thick phlegm and easing wheezing is intended to help with cough, excessive phlegm, chest tightness, shortness of breath, and wheezing, potentially making breathing feel easier.
| Related Products
The products below are provided for informational reference only and do not constitute medical advice or a prescription. Follow the product packaging and instructions, and use under the guidance of a doctor or pharmacist.
| Common Symptoms
Clinical Description:
Palpitations and shortness of breath, inability to lie flat, profuse sweating, a pale complexion, bluish-purple lips, sweating with cold limbs, weak breathing, coughing up frothy saliva or sputum, restlessness, scanty urine, and swelling. The tongue is pale with a white coating; the pulse is deep, faint, and nearly imperceptible.
In Plain Language:
- Feeling palpitations and shortness of breath, as if there is not enough air.
- Being unable to lie flat because doing so makes the discomfort worse.
- Heavy sweating, enough to soak clothing.
- The face looks very pale and lacks color.
- The lips appear bluish or purplish, with a dark, dull color.
- The hands and feet feel cold while sweating, and may feel icy to the touch.
- Breathing is shallow and weak, with little force when inhaling.
- Coughing up frothy saliva or sputum.
- Feeling restless and unable to sit still or calm down.
- Passing noticeably less urine, together with swelling of the body.
- The tongue appears pale with a white coating.
- The pulse feels deep and extremely faint, almost impossible to detect.
| Treatment Approach
Clinical Description:
Warm Yang and tonify qi; restore Yang and rescue from collapse.
In Plain Language:
- In TCM theory, warming Yang and supporting qi is intended to strengthen functional activity and may ease aversion to cold, cold hands and feet, shortness of breath, and fatigue.
- Restoring Yang and supporting heart Yang is intended to address pallor, spontaneous cold sweats, cold extremities, and very weak breathing, with the aim of helping stabilize the condition.
| Related Products
The products below are provided for informational reference only and do not constitute medical advice or a prescription. Follow the product packaging and instructions, and use under the guidance of a doctor or pharmacist.
References
- Komajda M, Jais JP, et al. Factors predicting mortality in idiopathic dilated cardiomyopathy[J]. Eur Heart J, 1990, 11(9): 824-831.
- Wang Zhimin, Zou Yubao, Song Lei, et al. Prevalence of hypertrophic cardiomyopathy among 8,080 adults assessed by echocardiography[J]. Chinese Journal of Cardiology, 2004, 32(12): 1090-1094.
- Shen Shaogong, Wang Chengde, Yan Xijun. Standards for TCM Diagnosis and Treatment Outcomes in Heart Disease and Medication Guidelines[M]. Beijing: Beijing Publishing House, 2001.
- Cardiovascular Disease Branch of the Chinese Medical Association, Editorial Board of the Chinese Journal of Cardiology, and Chinese Cardiomyopathy Diagnosis and Treatment Recommendations Working Group. Recommendations for the diagnosis and treatment of cardiomyopathy[J]. Chinese Journal of Cardiology, 2007, 35(1): 5-16.
- Manolio TA, Baughman KL, Rodeheffer R, et al. Prevalence and etiology of idiopathic dilated cardiomyopathy (summary of a National Heart, Lung, and Blood Institute workshop)[J]. Am J Cardiol, 1992, 69(17): 1459-1466.