Coronary Heart Disease Angina Pectoris
Coronary heart disease (CHD) is short for coronary atherosclerotic heart disease. It is primarily caused by atherosclerosis of the coronary arteries, which narrows or blocks the arterial lumen and leads to myocardial ischemia and hypoxia. Depending on the location and extent of coronary artery disease, the degree of vascular obstruction, and the rate at which inadequate blood supply to the myocardium develops, the 1979 WHO classification and diagnostic criteria for “ischemic heart disease” divide the condition into five types: occult or asymptomatic CHD, angina pectoris, myocardial infarction, ischemic cardiomyopathy, and sudden death. This section discusses angina pectoris associated with CHD.
TCM Pattern Differentiation and Medication Reference
|Common Symptoms
Clinical description:
Stabbing or dull pain in the precordial region; pain is localized and the affected area is tender to pressure; worse at night; dark, dusky complexion, or bluish-purple lips and nails, or subcutaneous ecchymoses; dark tongue or purple spots, distended sublingual veins; a choppy pulse or an irregular pulse with intermittent pauses
Plain-language explanation:
- There may be stabbing or dull pain in the chest, causing discomfort.
- The pain tends to stay in one place and does not move around much.
- Pressing on the painful area may make it more uncomfortable, and the area may be very tender.
- The pain may be more noticeable at night and often feels worse than during the day.
- The face may look dark or dusky, with little color or luster.
- The lips or nails may appear bluish or purplish and dark in color.
- Bluish-purple bruises with uneven coloration may appear under the skin.
- The tongue may look dark or have bluish-purple spots or patches, rather than a fresh, healthy color.
- The veins beneath the tongue may look prominent, enlarged, and tortuous.
- The pulse may feel uneven, or may occasionally seem to pause between beats.
|Treatment Approach
Clinical description:
Invigorate blood, dispel stasis, unblock the collaterals, and relieve pain
Plain-language explanation:
- Promote blood circulation and disperse blood stasis so that blood can flow more freely.
- Unblock obstructed channels and collaterals so qi and blood can flow more smoothly, thereby easing pain.
|Related Formulas
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 physician or pharmacist.
|Common Symptoms
Clinical description:
Dull pain in the precordial region; pain and a heavy feeling in the limbs and joints; a plump build and abundant phlegm; fullness and oppression in the chest and epigastrium; nausea and retching; poor appetite and abdominal bloating; a greasy tongue coating; a slippery or wiry pulse
Plain-language explanation:
- There may be a persistent dull ache in the chest, with a feeling of pressure.
- The limbs and joints may feel painful and heavy, especially when moving.
- The person may have a larger build and abundant, thick phlegm, often with a sensation of phlegm in the throat.
- The chest and upper abdomen may feel persistently full, tight, or uncomfortable.
- Nausea and an urge to vomit may occur, sometimes with retching.
- Appetite may be poor, with reduced food intake and a tendency to abdominal fullness and discomfort.
- The tongue coating may look thick and greasy, with a sticky appearance.
- On examination, the pulse may feel slippery or wiry.
|Treatment Approach
Clinical description:
Transform phlegm and drain turbidity; free the yang and unblock impediment
Plain-language explanation:
- Transform phlegm-dampness and help clear turbidity from the body, supporting smoother internal processes.
- Disperse obstruction, open blocked channels, and support yang so qi and blood can circulate more freely, helping the limbs feel warmer and the joints move more comfortably.
|Related Formulas
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 physician or pharmacist.
|Common Symptoms
Clinical description:
Severe, constricting heart pain that begins suddenly; worsened by cold and eased by warmth; aversion to cold, cold limbs, bland taste in the mouth and no thirst, or a preference for hot drinks; bluish complexion and purple lips; pale, dark tongue; thin coating; a deep and wiry or slow pulse
Plain-language explanation:
- There may be a gripping, squeezing pain in the chest.
- The pain may be severe and difficult to tolerate.
- The pain may come on suddenly, without an obvious warning.
- The pain may become noticeably worse in cold conditions.
- Warmth may ease the pain somewhat.
- The person may feel cold easily and prefer warm surroundings.
- The hands and feet may feel cold to the touch.
- The mouth may taste bland, with little or no thirst.
- Sometimes there may be a preference for hot drinks or warm water.
- The face may look bluish or dusky, and the lips may appear purplish.
- The tongue may look pale and somewhat dusky rather than red and healthy.
- The tongue coating may be thin.
- On examination, the pulse may feel deep and wiry, or slow.
|Treatment Approach
Clinical description:
Warm and unblock heart yang; open impediment and disperse stagnation
Plain-language explanation:
- Warm and support heart yang to dispel internal cold and help blood flow more freely and effectively.
- Disperse obstruction and resolve stagnation so the channels are more open and qi and blood can flow more smoothly, potentially easing related tightness and pain.
|Related Formulas
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 physician or pharmacist.
|Common Symptoms
Clinical description:
Faint, dull pain in the precordial region, worsened by exertion; thin build; weak, low voice; dry mouth and desire to drink; heat in the palms, soles, and chest; tidal fever and night sweats; flushed cheeks; red tongue; thin coating with little moisture; a fine, rapid or deep, fine pulse
Plain-language explanation:
- There may be a faint, dull ache in the chest.
- Pain may worsen with activity or exertion.
- The person may be thin or noticeably underweight.
- The voice may be quiet and low, with little strength behind it.
- The mouth may feel dry, with a desire to drink.
- The palms and soles may feel warm, along with a sensation of heat in the chest.
- There may be episodes of feverish warmth in the afternoon or evening, along with night sweats.
- The cheeks may appear flushed.
- The tongue may look red.
- The tongue coating may be thin, with little moisture, and the tongue surface may feel dry.
- The pulse may feel fine and rapid, or deep and fine.
|Treatment Approach
Clinical description:
Tonify qi and nourish yin; unblock the collaterals and relieve pain
Plain-language explanation:
- Support the body’s qi and nourish yin fluids to help restore energy, ease dry mouth, and address internal dryness.
- Unblock obstructed channels so qi and blood can circulate more smoothly, potentially easing pain and numbness.
|Related Formulas
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 physician or pharmacist.
|Common Symptoms
Clinical description:
Dull pain and tightness in the precordial region, worsened by cold; aversion to cold; fatigue and reluctance to speak; pale, lusterless complexion; spontaneous sweating; soreness and weakness of the lower back and knees; cold lower back; aversion to cold and cold limbs, especially the lower limbs; difficulty urinating or copious, clear urine; pale, swollen tongue with teeth marks; thin white coating; a deep, fine or faint pulse
Plain-language explanation:
- There may be a tight, dull ache in the chest, with a feeling of pressure and discomfort.
- The pain may become noticeably worse in cold conditions.
- The person may feel cold easily and prefer warm surroundings.
- There may be fatigue and weakness, with little desire to speak.
- The face may look very pale and lack a healthy color.
- Sweating may occur without physical activity and may become more noticeable with slight movement.
- The lower back and knees may often feel sore and weak.
- The lower back may feel cold and sensitive to cold.
- The person may feel cold, with cold hands and feet; the legs and feet may feel especially cold.
- Urination may be difficult, or the urine may be clear and pale, with a large volume or prolonged urination.
- The tongue may look pale and somewhat swollen.
- Teeth marks may be visible along the edges of the tongue.
- The tongue coating may be thin and white.
- On examination, the pulse may feel deep and fine, or faint and weak.
|Treatment Approach
Clinical description:
Warm and tonify the heart and kidneys
Plain-language explanation:
- Warm and support the yang and vital qi of the heart and kidneys, helping dispel internal cold and support warmth and energy throughout the body.
- Nourish the qi, essence, and blood of the heart and kidneys to support calm and vitality, with the aim of easing discomfort such as palpitations, insomnia, soreness and weakness of the lower back and knees, and aversion to cold with cold limbs.
|Related Formulas
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 physician or pharmacist.
References
- Wu Zhaosu, Yao Chonghua, Zhao Dong, et al. Population-based surveillance of cardiovascular disease trends and determinants in multiple provinces and cities in China (China MONICA Project), Part I: Results of incidence and mortality surveillance [J]. Chinese Journal of Cardiology, 1997, 25(1): 6–11.
- China Association of Chinese Medicine. Guidelines for the Diagnosis and Treatment of Common Internal Diseases in Traditional Chinese Medicine: TCM Disease Patterns [M]. China Press of Traditional Chinese Medicine, 2008: 39–42.
- Cardiovascular Disease Branch of the Chinese Medical Association, Editorial Board of the Chinese Journal of Cardiology. Guidelines for the Diagnosis and Treatment of Chronic Stable Angina [J]. Chinese Journal of Cardiology, 2007, 35(3): 195–206.