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Patterns of Disharmony > Heart Patterns > Flashcards

Heart Patterns Flashcards

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1
Q

Functions of the heart

A

Governs Blood

Houses the Shen (mind)

Controls sweat

Opens into the mouth

Controls the blood vessels

Opens onto the tongue

Manifests in the complexion

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2
Q

General aetiology of heart patterns

A

Exterior pathogenic factors

Emotions (joy, sadness and grief, anger, worry)

Diet

Overwork

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3
Q

Exterior pathogenic factors affecting the Heart?

A

Fire

Heat

(If exterior pathogenic factors attack the heart, they penetrate the pericardium instead).

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4
Q

Which emotions affect the Heart

A

Joy - Excessive joy and overstimulation can injure the heart by slowing down Heart Qi, making it deficient, and dilating the heart.

Sadness and grief - Within the 5-element theory sadness and grief deeply affect the Heart Qi (as well as the Lungs). Prolonged sadness and grief will cause Qi deficiency which over time may lead to stagnation, which can turn into Heart-heat.

Anger - The rising of Liver-Yang or Liver-Fire can lead to Heart-Fire.

Worry - Worry knots Qi causing stagnation Lung and Spleen Qi due to shallow breathing and overthinking. Additionally, worry knots Heart Qi causing palpitations, tightness in the chest and insomnia.

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5
Q

Heart Qi deficiency - Clinical manifestations

A

*Palpitations

Shortness of breath on exertion

Pale face

Spontaneous sweating

Tiredness

Slight depression

Tongue: Pale or normal

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6
Q

Heart pathology

A

Palpitations (light and occassional)

Mental-emotional issues

Reflected in the Shen of the eyes

Depression, anxiety, insomnia

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7
Q

Heart Qi deficiency - Aetiology

A

Emotional problems (particularly sadness or grief)

Blood Loss (Blood is the mother or Qi. Therefore, Heart-blood deficiency will lead to Heart Qi deficiency).

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8
Q

Precursors to Heart Qi Deficiency

A

Kidney Qi deficiency

Gall Badder Qi deficiency

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9
Q

Developments from Heart Qi deficiency

A

Heart Yang deficiency

Lung Qi deficiency (especially with emotional stress)

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10
Q

Treatment Principle - Heart Qi deficiency

A

Tonify Heart Qi

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11
Q

Acupuncture points for Heart Qi deficiency

A

H5 - Tonifies Heart Qi

P6 - Tonifies Heart Qi (particularly useful in sadness)

BL15 - Back Shu, Tonifies Heart Qi, direct moxa

Ren17 - Gathering point of Qi, tonifies Qi of the upper burner (useful for sadness as tonifies both Lung and Heart)

Ren6 - tonifies whole body Qi

Du14 - Tonifies Heart Qi, direct Moxa

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12
Q

Heart Yang deficiency - Clinical manifestations

A

*Palpitations

Shortness of breath on exertion

bright Pale face

Slightly dark lips

Spontaneous sweating

Tiredness

A slight feeling of stuffiness in the heart area

Feeling cold

*Cold hands

Slight depression

Tongue: Pale slightly wet

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13
Q

Heart Yang deficiency - aetiology

A

The same as Heart Qi deficiency: Emotional problems (particularly sadness or grief)

Blood Loss (Blood is the mother or Qi. Therefore, Heart-blood deficiency will lead to Heart Qi deficiency).

Indirectly caused by any of the causes of Kidney Yang deficiency.

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14
Q

Heart Yang deficiency - pathology

A

Same as Heart Qi deficiency as included within Yang deficiency: Palpitations, shortness of breath, tiredness, sweating, pale face.

Feeling cold, cold hands - heart yang not transporting blood to the extremities.

Stuffiness in chest - Heart Yang not moving Qi in the chest leading to slight stagnation.

Slightly dark lips (severe/advanced cases) - Heart Yang failing to move Qi and blood causing a slight blood stasis.

Pale, wet tongue - Heart Yang cannot transport enough blood to the tongue, or transform fluids which accumulate on the tongue.

Deep, weak pulse - deficiency of Yang
Knotted (severe cases) - a slow pulse that stops at irregular intervals).

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15
Q

Heart Yang deficiency - Precursors

A

Kidney Yang deficiency - Kidney Yang is the source of all Yang energies of the body.

Heart Qi deficiency

Stomach/Spleen Yang deficiency.

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16
Q

Heart Yang deficiency - Developments

A

Heart blood stasis - Deficient Heart Yang failing to move Heart Qi leads to Heart Qi stagnation and then to Heart Blood Stasis (angina pectoris and coronary heart disease).

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17
Q

Heart Yang deficiency - treatment principles

A

Tonify and warm Heart Yang

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18
Q

Heart Yang deficiency - Acupuncture points

A

HE5 - Tonify Heart Qi

P6 - Tonify Heart Qi

BL15 - Tonifies Heart Yang if Moxa is used

Ren17 - Tonifies Heart Yang if Moxa is used (particularly useful when there is stuffiness in the chest).

Ren6 - With moxa Tonifies all Yang energies. Especially useful if derived from Kidney Yang deficiency.

Du14 - with direct moxa tonifies Heart-Yang

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19
Q

Heart Yang Collapse - Clinical Manifestations

A

Palpitiations

Shortness of breath

Weak and Shallow breathing

Profuse sweating

*cold limbs

*cyanosis of the lips

Greyish white complexion

Coma! (severe cases)

Tongue: very pale or bluish-purple, short

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20
Q

Heart-Yang collapse - Aetiology

A

Directly: Chronic and severe Heart Yang deficiency

Indirectly: Excessive sexual activity, chronic overwork, chronic illness.

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21
Q

Heart-Yang collapse - Pathology

A

The same as Heart-Yang deficiency but more severe.

Additionally: cyanosis of the lips - deficient yang Qi not moving the blood causing severe stasis.

Coma - complete collapse of the Heart Qi, mind has no ‘residence’. Deficient coma.

Short tongue: Deficient yang Qi cannot move the tongue muscle and internal cold contracts the tongue muscle.

Hidden pulse - a severe kind of deep pulse due to severe yang deficiency. Knotted is due to deficient Yang not giving the heart enough energy to beat regularly.

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22
Q

Heart-Yang collapse - precursors

A

Always derived from a chronic and severe Kidney Yang deficiency.

Stomach/Spleen Yang deficiency

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23
Q

Heart-Yang collapse - developments

A

Cardiac infarction/heart attack

Severe blood stasis

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24
Q

Heart-Yang collapse - treatment principle

A

Rescue Yang

Restore consciousness

Stop sweating

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25
Heart-Yang collapse - Acupuncture
All reinforcing method, no needle retention, moxa must be used. Ren4, Ren6, Ren8 - rescue Yang Qi and stop sweating if indirect moxa on ginger or aconite is applied. Du4 - with moxa tonifies kidney Yang St36, P6 - strengthen heart Yang BL23 - with moxa strengthens Kidney Yang Du20 - meeting point of all the Yang channels: rescues Yang and promotes resuscitation if used with direct moxibustion.
26
Heart Blood deficiency - Clinical manifestations
*Palpitations Dizziness *Insomnia Dream-disturbed sleep *Poor memory Anxiety Propensity to be startled Dull-pale complexion Pale lips *Tongue: Pale, Thin, slightly dry
27
Heart Blood Deficiency - Aetiology
Diet - Spleen Qi deficiency - a diet lacking in nourishment or blood-producing (such as meat) can lead to Spleen Qi deficiency. Chronic Spleen Qi deficiency can lead to Blood deficiency which can in turn weaken the Heart and cause Heart-Blood deficiency. Emotional Stress - Sadness, anxiety and worry, and grief over a long period can disturb the mind and depress the heart function. Since the heart governs blood this eventually leads to Heart-Blood deficiency. Severe blood loss (Chinese medicine holds this to be the main cause of postnatal depression).
28
Heart Blood Deficiency - Pathology
Heart anchors the Shen - The mind is deprived of its residence - Insomnia, anxiety, dream-disturbed sleep, propensity to be startled. Heart controls the mental faculties - Dull thinking, poor memory. Blood is the mother of Qi - Heart Blood deficiency may also lead to Heart Qi deficiency. Palpitations - Daytime (Qi deficiency) Nightime (Blood deficiency) Dizziness - Blood not nourishing the brain Pale, dry tongue - not enough blood reaching the tongue. Dryness differentiates from Heart-Yang deficiency
29
Heart Blood Deficiency - Precursors
Liver Blood deficiency - Liver is the mother of the Heart in 5-element theory.
30
Heart Blood Deficiency - Developments
Heart Yin deficiency - Blood is part of Yin. Heart Blood deficiency may effect the Spleen as Heart is the mother of Spleen in 5-elements causing pensiveness and brooding.
31
Heart Blood Deficiency - treatment principle
Nourish Blood Tonify the Heart Calm the Shen
32
Heart Blood Deficiency - Acupuncture
All with reinforcing method, moxa can be used HE7 - Nourishes Heart-Blood and calms the Shen. Ren14, Ren15 - Tonify Heart Blood and calm the Shen (anxiety) Ren4, BL17 (Gathering point for Blood), BL20 (Spleen Back Shu) - Tonify Blood
33
Heart-Fire blazing - Clinical Manifestations
*Palpitations *Thirst *Mouth and tongue ulcers Mental restlessness Feeling agitated Feeling hot Insomnia Dream-disturbed sleep Red face Dark Urine or blood in the urine Bitter taste (after a bad's night sleep) *Tongue: Red, tip redder and swollen with red points, yellow coating. There may be a midline crack reaching the tip.
34
Heart-Fire Blazing - Aetiology
Emotional stress - Chronic anxiety, constant worrying, and depression over a long period can lead to Qi stagnation, which can eventually lead to fire. Diet - Excessive hot--energy foods (spices, red meat, but especially alcohol)
35
Heart-Fire Blazing - Pathology
Excess, Full Heat - thirst, red face, feeling of heat. Red tongue, rapid overflowing or hasty pulse. Ulcers - The tongue is an offshoot of the heart, and fire can flare up toward the tongue (ulcers with red rim usually fire, a white rim may be empty-heat/yin deficiency). Mental restlessness/insomnia - Excess heat disturbing the mind. More severe than Heart-yin deficiency. Frequent night waking and disturbing dreams. Red face - heat flaring upwards and manifesting in the complexion (whole face red rather than malar flush of yin deficiency). Bitter taste - The heart opens into the tongue, and controls taste. Differs from Liver-fire as bitter taste only in the morning and only after a sleepless night. Dark urine/blood - Heart fire transmitting to the small intestine and from this to the Bladder (Greater Yang)
36
Heart-fire Blazing - precursors
Liver-Fire - Liver is the mother of the Heart within 5-element theory. Also shared emotional origin of Heart/Liver patterns. Anger, frustration and resentment may lead to Liver-Fire as these are recognised by the Shen housed in the Heart Liver-Fire is transmitted to the Heart.
37
Heart-Fire Blazing - Developments
Spleen-Heat Stomach-Fire
38
Heart-Fire Blazing - Treatment Principle
Clear the Heat. Drain Fire Calm the Shen
39
Heart-Fire Blazing - Acupuncture points
HE9, HE8 - Reduce Fire HE7 Calm the Shen Ren15 - Calms the Shen and clears Heat SP6, KID6 - Promote Yin and cool Fire. LI11 - Clears Heat DU24, DU19 Calm the Shen
40
Phlegm- Fire harassing the Heart - Clinical Manifestations
*Palpitations *Thirst A feeling of oppression in the chest Mental restlessness Expectoration of phlegm Rattling sound in the throat Feeling agitated Insomnia Dream-disturbed sleep *Incoherent speech *Mental confusion *Rash behaviour *Tendency to hit or scold people *Muttering to oneself *Uncontrolled laughter or crying *Shouting *Manic behaviour Depression *Tongue: Red, swollen, yellow dry sticky coating, deep heart crack, the tip may be red and swollen with red points.
41
Phlegm-Fire Harassing the Heart - Aetiology
Emotional Stress - severe emotional problems and depression lead to stagnation of Qi, eventually turning to Fire. Diet - Excessive consumption of hot greasy foods creates Heat and Phlegm
42
Phlegm-Fire Harassing the Heart - Pathology
Excess pattern Mental symptoms - Phlegm obstructing the Heart offices and disturbing the Shen. It differs from Heart-Fire in that it involves a lack of insight due to phlegm clouding the mind and the agitation caused by Fire. Could present as bipolar.
43
Phlegm-Fire Harassing the Heart - Precursors
Spleen Deficiency (possibly Lung/Kidneys) - presence of Phlegm Spleen deficiency leads to the formation of Phlegm, but Fire contributes as it condenses it.
44
Phlegm-Fire Harassing the Heart - developments
Yin deficiency - Heart Fire may injure Yin Spleen Qi deficiency - Phlegm obstructs Qi Blood Stasis - Fire condenses Blood and phlegm is linked to Blood through Body fluids.
45
Phlegm-Fire Harassing the Heart - Treatment
Clear the Heart Drain Fire Resolve Phlegm Calm the Shen Open the Mind's offices.
46
Phlegm-Fire Harassing the Heart - Acupuncture points
P5 - Resolves phlegm from the mind and clears orifaces H7 - Calms the Shen H8, H9 - clear Heart-Fire P7 - Calms the Shen and clears Heart-Fire Ren15 - Pacifies the Mind BL15 - Clear Heart-Fire Ren12 - Tonifies Spleen to resolve phlegm ST40 - resolves phlegm SP6 - resolves phlegm and calms the Shen BL20 - Tonifies the Spleen to resolve Phlegm LIV2 - subdues Fire to conduct it downwards GB13 and DU24 Calm the Shen GB17 Opens the Mind's orifices.
47
Phlegm misting the Mind - Clinical manifestations
*Mental Confusion Unconsciousness Lethargic stupor Incoherent Speech Slurred Speech Aphasia Vomiting of Phlegm *A rattling sound in the throat Mental depression Very dull eyes *Tongue: Swollen with thick sticky coating, midline crack reaching the tip (Heart crack)
48
Phlegm misting the Mind - Aetiology
Constitution - in children Diet - Excessive consumption of greasy raw foods leads to the formation of Phlegm. Severe emotional problems such a long-standing anxiety can combine with the dietary origin to obstruct the Heart.
49
Phlegm misting the Mind - Pathology
Excess pattern Similar to Phlegm-Fire harassing the Heart with the absence of Fire and seen in different patients and situations. Children - Speach difficulties or mental retardation Adults - Maybe after an attack of Wind-stroke causing coma, paralysis and aphasia. Mental confusion, lethargic stupor and unconsciousness - Phlegm obstructing the Heart and therefore the Shen/Mind. Apasia - Heart opens into the tongue and the phlegm stops the tongue from moving. Vomiting and rattling sounds in the throat are caused by phlegm obstructing the chest. Swollen tongue body, sticky coating, slippery pulse - phlegm.
50
Phlegm misting the Mind - Precursors
Spleen, Lung and Kidney deficiency leading to Phlegm - in adults.
51
Phlegm misting the Mind - Developments
Qi deficiency - Obstruction of Qi by Phlegm Dryness and blood stasis - long-standing retention of Phlegm.
52
Phlegm misting the Mind - Treatment Principles
Open the Heart Resolve Phlegm Open the Mind's orifices
53
Phlegm misting the Mind - Acupuncture points
*P5 - resolves Phlegm from the Heart H9 - Clears the Heart and opens its orifices (if unconscious, could be bled) BL15 - Clears the Heart and is particularly useful in children to clear Phlegm from the Heart. Will stimulate the child's intellectual abilities and speech. ST40 - resolves Phlegm DU26 - restores consciousness REN12 and BL20 - tonify the Spleen to resolve Phlegm DU14 - clears the Heart and tonifies Heart-Yang; heart-yang mobilises the Phlegm.
54
Heart-Qi Stagnation - Clinical manifestations
Palpitations A feeling of distension or oppression of the chest Depression A slight feeling of a lump in the throat Slight shortness of breath Sighing Poor Appetite Slight nausea Cold limbs Slightly purple lips Pale complexion Tongue: Slightly pale-purple on the sides in the chest area.
55
Heart-Qi Stagnation - Aetiology
Emotional stress - Sadness, grief, worry. More likely to occur when there is a pre-existing Liver-Qi stagnation.
56
Heart-Qi Stagnation - Pathology
Distension in the chest and the slight feeling of a lump in the throat and sighing all indicate Heart-Qi stagnation. Pale complexion - stagnant Heart-Qi in the chest fails to ascend to the face. Poor appetite/nausea - Heart-Qi not descending towards the stomach.
57
Heart-Qi Stagnation - Precursors
Liver Qi stagnation - affects the free flow of Qi to any organ so when subjected to emotional distress the Heart-Qi is easily affected. Heart-Qi deficiency - sadness and grief, deficient Qi dies not circulate properly and may lead to stagnation. Thus Qi can be both deficient and stagnant.
58
Heart-Qi Stagnation - Developments
Heart-Blood stasis - a more serious pattern Liver Qi stagnation
59
Heart-Qi Stagnation - Treatment Principle
Move Heart-Qi Open the chest Calm the Shen
60
Heart-Qi Stagnation - Acupuncture
P6 - Opens the chest, moves Qi and Calms the Shen. HE5 - moves Heart Qi and calms the Shen. HE7 - Calms the Shen LU7 - moves Qi in the chest ST40 - opens the chest and moves Qi in the chest.
61
Heart-Blood stasis (stagnation) - clinical manifestations
Palpitations *Stabbing or pricking pain in the chest which may radiate to the inner aspect of the left arm or to the shoulder. Feeling of oppression of constriction of the chest *Cyanosis of lips or nails Cold hands *Tongue: Purple in its entirety or only on the sides in the chest area
62
Heart-Blood stasis (stagnation) - Aetiology
Emotional stress - Heart-Blood is the physiological basis for the Mind.
63
Heart-Blood stasis (stagnation) - Pathology
Derived from other Heart patterns mostly Heart-Yang deficiency, Heart-Blood deficiency or Heart Qi stagnation. Additional symptoms will help to determine the origin pattern. Either mixed deficiency/excess pattern or Excess depending on the origin pattern. Chest pain is the key symptom. Cyanosis of the lips and cold hands are due to stagnant Heart-Blood not reaching the face and hands. Purple tongue - reflects stasis of Blood and may be blueish reflecting the internal cold from deficiency of Yang causing stasis of Blood.
64
Heart-Blood stasis (stagnation) - Precursors
Heart-Yang deficiency. Heart-Qi stagnation Liver Qi stagnation - The Liver channel affects the chest, and the loss of free flow of Liver-Qi may easily affect the Heart. Leading to Heart-Qi stagnation first and then Heart-Blood stasis.
65
Heart-Blood stasis (stagnation) - Developments
Phlegm - due to the interaction of these two pathogenic factors. A long-term consequence of Blood stasis, especially in the elderly, can be dryness.
66
Heart-Blood stasis (stagnation) - Treatment Principle
Move Blood Eliminate Stasis Tonify and warm Heart-Yang Calm the Shen
67
Heart Qi Xu pulse
EP - Slow, Irregular rate/rhythm, Rough vibration LDP - Reduced, feeble/absent, flat
68
Heart Yang Xu Pulse
EP - Rapid or slow, arrhythmic, interrupted LDP - Deep, absent or empty, flat
69
Heart Blood Xu - Pulse
Increases more than 12/beats/min on exertion LDP - Thin
70
Heart Yin Xu - Pulse
EP - Hesitant LDP - Tight, also thin is Yin Xu comes from Blood Xu, or robust or reduced pounding if Yin Xu is more from Heat.
71
Heart Fire Blazing - Pulse
EP - Rapid, Full/Overflowing, possibly Rate and Rhythm changes LDP - Robust Pounding
72
Phlegm - Fire Harassing the Heart - Pulse
LDP - Tense-tight, slippery LMP - Tense, robust pounding RMP - Feeble/Empty
73
Phlegm misting the mind - Pulse
LDP - Slippery, Feeble RMP - Feeble, empty, reduced RDP - Reduced, possibly feeble
74
Heart Qi Stagnation - Pulse
LDP - Flat, tense
75
Heart Blood Stagnation - Pulse
LDP - Flat, Choppy, later: Deep, thin, feeble

Patterns of Disharmony (6 decks)

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