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Flashcards in Chest Bi Deck (42):
0

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

1

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

2

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

3

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

4

Oppression and intermittent pain in the chest, SOB, palpitations, lumbar soreness, chills, cold limbs, Edema, pale complexion and lips

Yang Qi Def

5

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

6

Oppression and intermittent pain in the chest, dizziness, tinnitus, dry throat, 5 palm heat, insomnia, restlessness, palpitations, lumbar soreness

Heart and Kidney Yin Def

7

Oppression and pain in chest, palpitations, SOB, dizziness, fatigue, insomnia, sallow complexion

Qi and Yin Def

8

Retention of Turbid Phlegm in the Chest T and P

T: Thick, sticky and turbid
P: Soft and Moderate

9

Retention of Turbid Phlegm in the Chest POT

Disperse obstruction of chest yang
Promote circulation of Qi to expel phlegm

10

Retention of Turbid Phlegm in the Chest Points

St 40
Sp 9
Gb 34

11

Heart Blood Stag T and P

T: Dark purple with ecchymoses
P: Wiry, choppy or intermittent

12

Heart and Blood Stag POT

Quicken Qi and Blood to remove Blood stasis

13

Heart Blood Stag Points

Liv 3
Li 4
Sp 10
UB 17

14

Stagnation of Cold in the Chest T and P

T: White and slippery or white and sticky
P: Deep and slow

15

Stagnation of Cold in the Chest POT

Circulate the chest yang
Dissipate pathogenic cold

16

Stagnation of Cold in the Chest Points

Moxa at Ren 17
Pc 8
K 1

17

Chest Bi Basic Points

Ren 14/17 or UB 14/15
Pc 4/6
Hrt 6/7

18

Heart and Kidney Yin Def. T and P

T: Red or dark purple
P: Thready and wiry or thready and rapid

19

Heart and Kidney Yin Def. POT

Nourish Yin
Move Blood
Calm the mind

20

Heart and Kidney Yin Def. Points

K 6 or Sp 6

21

Qi and Yin Def. T and P

T: Tender red
P: Thready or knotted

22

Qi and Yin def. POT

Tonify Qi and Blood
Move Blood in the collaterals

23

Qi and Yin Def. Points

St 36 or Ren 6
K 6 or Sp 6

24

Yang Qi Def T and P

T: Dark purple with white tongue coating
P: Deep thready or intermittent

25

Yang Qi Def POT

Tonify Qi
Warm yang
Move blood in the collaterols

26

Yang Qi Def Points

Du 4
Ren 4-8
Moxa

27

Tests

EKG - Needs to be happening during an attack
Q and R base line will be raised indicating a heartattack

28

Main Organ and Correlating Organs

Main Organ: Heart

Related to: Liver, Spleen, Stomach, Kidney,Lung(Pulmonary Circulation)

29

Corresponding Western Diseases

Coronary Heart Disease
Angina
Heart Attack

30

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

31

Chief Pathology

Root Deficient - Heart yin and Heart Yang, sometimes kidney

Branch Excess- Phlegm, blood stasis, Qi stag, cold damp (Xie Qi)

32

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. Pleurisy

PAINFUL BREATHING

3. Chest Bi Vs. Palpitations

Chest pain CHIEF COMPLAINT Palpitations

33

Pattern Differentiation

In acute stage separate the Biao and Ben

ie. severe pain alleviated by warmth, aggravated by cold

34

POT

Look at Biao and Ben

During attack Biao is dominate - if phlegm transform phlegm etc.
In Remission its Ben

35

Tx

1. Basic Points: Ren 14/17 or UB 14/15 - Front mu/Back shu combo
Pc 4/6
Hrt 6/7
2. Moxa Ren 17 to warm chest yang, Pc 6, UB 14/15, St 36
Choose 2-3 pts for 20 min
3. Jiaji T4-T5 - Around heart and Pc back shu
4. Palpate Backshu/Du points on upper back for tender spots or places of color changes and needle those reactive spots
5. Palpate around Kid 22 on the left and needle tender pts
6. 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

36

Main types of points to needle

Front Mu
Back Shu
Yuan Source
XiCleft

37

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

38

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

39

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!

40

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

41

Def

Partial Blockage of the Cardiac Vessels - Myocardial Infarction

* Medical History Important!
*Nitroglycerin
* Will usually die within 30 min