Palpitations - Xin Ji
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Definition
A condition marked by feeling of abnormal heartbeats with anxiety. Most involuntary and uncontrollable. There are palpitations due to fright (Jing Ji) and common palpitation (Zheng Chong).
Causes and Pathological Mechanisms
- Constitution weakness and emotions: timidity with sudden frights; extreme anger impairs the Liver or extreme fright impairs the Kidney leading to Shen “shock”
- Heart Blood Deficiency: long term illness, loss of Blood, Spleen Qi Deficiency failing to produce blood. Heart Shen loses nourishment
- Yin Deficient Fire: long term illness impairs Kidney Yin or Constitution kidney yin deficient. Water fails to control Fire. Deficient Fire disturbs heart Shen
- Heart Yang Deficiency: long term illness or major illness leads to Yang Deficiency which fails to warm the Heart
- Water and Rheum invasion of the Heart: Spleen Qi Deficiency and Kidney Yang Deficiency fails to transform Water. Water accumulates into rheum and invades the Heart. Heart Yang is suppressed
- Blood Stasis obstructs the Collaterals: Heart Yang Deficiency causes sluggish blood circulation; or Wind, Cold and Dampness evils struggle with the Vessels and invade the Heart causing blockages and sluggish circulation
Patterns
Heart Qi Deficiency and Blood Deficiency
- Symptoms: Palpitation, susceptible to fright, fidgeting and restless, insomnia and dreams.
- Tongue: Thin white tongue coating
- Pulse: Rapid or Weak and Wiry
- Treatment strategy: Calm fright, nourish heart and tranquillise shen
- Formula: An Shen Ding Zhi Wan
- Acupoints:
- Symptoms: Palpitation, dizziness, pale complexion and tiredness.
- Tongue: Pale tongue
- Pulse: Weak and Thready
- Treatment strategy: Tonify qi and replenish blood to nourish heart and shen
- Formula: Gui Pi Tang
- Acupoints:
- Symptoms: Palpitation, restlessness, vexation, insomnia, dizziness, blurred vision, feverish sensation in palms and soles, tinnitus and lower back ache.
- Tongue: Red tongue with little or no coating
- Pulse: Thready and Rapid
- Treatment strategy: Nourish yin to clear fire and nourish heart to pacify shen
- Formula: Tian Wang Bu Xin Dan
- Acupoints:
- Symptoms: Palpitation and restlessness, chest distension and breathlessness, pale complexion, chill and cold limbs.
- Tongue: Pale tongue
- Pulse: Weak or Deep and Thready
- Treatment strategy: Warm to tonify heart yang and pacify shen
- Formula: Gui Zhi Gan Cao Long Gu Mu Li Tang
- Acupoints:
Water and Rheum Invade the Heart
- Symptoms: Palpitation, dizziness, chest and epigastrium distension, chill and cold limbs, oliguria, with or without oedema in lower limbs, thirsty but no desire for water, nausea and vomiting saliva.
- Tongue: White and slippery tongue coating
- Pulse: Wiry and Slippery
- Treatment strategy: Revitalise heart yang to promote circulation and remove water
- Formula: Ling Gui Zhu Gan Tang
- Acupoints:
- Symptoms: Palpitation and restlessness, chest distension with intermittent chest pain.
- Tongue: Bluish purple tips, dull purple tongue with or without ecchymosis
- Pulse: Uneven or Intermittent
- Treatment strategy: Promote blood circulation and regulate qi flow to resolve stasis and to blockages
- Formula: Tao Ren Hong Hua Jian
- Acupoints:
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