Palpitations

Palpitations are the pounding or racing of the heart and may be accompanied by shortness of breath, fatigue and an irregular pulse which may be short and fast or rapid. Palpitations are usually due to lack of support from another organ creating a Heart deficiency or an external pathogenic factor blocking the Heart meridian.

Western medicine – this accompanies heart disorders, chronic fatigue, anxiety, etc.

Etiology (causes):

Primary Causes

1. General Body Qi Def - giving rise to HT deficiency

2. Emotional Stress - causes LV Qi Stag – impairs HT function- causing LV Qi Stag – blood stag. – blocks HT meridian – impairs HT function-dysfunction of SPulse - damp/phlegm blocks meridian – SP can’t produce blood to nourish HT

3. Chronic Illness-consumes HT Qi and Yin

Secondary Causes

1. Chronic Bi Syndrome- pathogens follows meridian and enters HT

2. Acute/Chronic Bleeding- blood Def. – HT isn’t nourished

3. Epidemic Febrile Disease - Toxic heaTongue - attacks HT

4. Chronic Cough/Asthma-LU Qi/Yang Def. with Phlegm – creates HT Qi Def.

Differentiate: Running Piglet Syndrome– feeling starts in Low Jiao and goes up to throat- Kidney Disorder

Chinese Medicine Differentiation and Treatment

Heart Qi DeficiencyHeart can’t push blood and can’t nourish itself, Palpitations with shortness of breath, dizziness, fatigue, spontaneous sweat, agg. by activity and amel. By rest. Tongue - pale Pulse - thin, weak

Principle of Treatment: Nourish heart Qi and nourish Yin

Acupuncture points – BL 14, 15 (Heart Yang), Ren 4, 6 (Moxa), PC 6 and HT 7 (palpitations)

Herbal Medicine Formula: Wu Wei Zi Tang

Heart Yang Deficiency Palpitations, aversion to cold, scanty urine, edema, cold symptoms, shortness of breath, dizziness, fatigue, spontaneous sweat Pulse - deep

Principle of Treatment: Warm and Strengthen Heart Yang

Acupuncture points – BL 14, 15 (Heart Yang), Ren 4, 6 (Moxa), PC 6 and HT 7 (palpitations)

Herbal Medicine Formula: Bao Yuan Tang Ling Gui Zhu Gan Tang – induce diresis if edema

Heart Yin Deficiency Palpitations induced by fear with insomnia, dysphoria, 5-centre heat sensation, fever, night sweat, yin def. symptoms Tongue - red, scanty dry coat Pulse - thin, rapid

Principle of Treatment: Nourish heart Yin and calm heart to relieve palpitations

Acupuncture points – BL 23, KI 3, HT 7, 6 - 5 centre heaTongue - KI 1, PC 8

Herbal Medicine Formula: Tian Wang Bu Xin Dan

Heart and Spleen Deficiency Palpitations with shortness of breath, dizziness, insomnia, poor appetite, soft stools, pale face Tongue - pale, puffy Pulse - weak

Principle of Treatment: Nourish heart and spleen

Acupuncture points – tonify BL 15 and Ren 14, BL 20, ST 36, BL 17 (blood) - loose stool – ST 25, 37 Herbal Medicine Formula: Gui Pi Tang

Heart Qi / Blood Deficiency Palpitations, shortness of breath, dizziness, short of breath, pale

Principle of Treatment: Nourish heart Qi and Blood

Herbal Medicine Formula: Zhi Gan Cao Tang

Liver and Kidney Yin DeficiencyPalpitations with insomnia, 5-centre heat sensation, back/knee ache/weakness, dizziness, tinnitus, blurred vision, reproductive disorders, LV/KD Yin Def. Symptoms. Tongue - red, thin coat Pulse - thin, rapid

Principle of Treatment: Nourish Liver – Kidney and Heart to calm the mind

Herbal Medicine Formula: Yi Guan Jian - nourish liver and kidney + Suan Zao Ren Tang - nourish heart

Spleen and Kidney Yang Deficiency Palpitations with fatigue, tired, aversion to cold, cold limbs, cold body, poor appetite, soft stool, scanty urine Tongue - swollen, pale, white coat Pulse - deep, thin, retarded

Principle of Treatment: Warm Spleen and Kidney and Induce diresis to calm heart

Herbal Medicine Formula: Li Zhong Tang + Zhen Wu Tang (induce diresis)

Heart and Gall Bladder Qi Deficiency Palpitations with fear, timid person, lots of dreams, fearful of lights and sounds, poor appetite T - pale Pulse - thin, wiry

Principle of Treatment: Nourish Heart and Gall Bladder Qi to calm the mind

Acupuncture points – BL 15, Ren 14, BL 19, PC 5 (ghost), HT 7 - timid, edgy, easily scared – PC 7 - spontaneous sweat, shortness of breath – ST 36, KI 7

Herbal Medicine Formula: Ping Bu Zhen Xin Dan, Wen Dan Tang

Turbid Phlegm StagnationPalpitations due to poor diet or over thinking causing dysfunction of spleen, shortness of breath, fullness/distended chest, easily nausea, bloated, poor appetite, heavy feeling Tongue - teeth marks, slippery/greasy coat Pulse - wiry, slippery

Principle of Treatment: regulate Qi to transform phlegm

Herbal Medicine Formula: Dao Tan Tang, Wen Dan Tang (phlegm heat)

Blood Stasis Palpitations with shortness of breath, dysphoria, fullness in chest, slight pain in head Tongue - purple veins under tongue Pulse - irregular

Principle of Treatment: promote blood circulation, remove blood stasis

Acupuncture points – neutral, PC 6, Ren 17, BL 15, Moxa Ren 6, BL 17, SP 10 - insomnia – HT 7

Herbal Medicine Formula: Xue Fu Zhu Yu Tang

Fluids attack Heart palpitations and water retention, frothy watery Phlegm with cough, chest fullness, dyspnea, difficult to lay flat, facial and/or ankle edema, scanty urine, dizziness, P- slippery wiry

Principle of Treatment – invigorate Yang Qi, transform water

Acupuncture points – hand shaoyin, Ren, Ren 4 and BL 23 (KI Yang), SP 9 (diuresis), PC 6 and HT 7 (palpitations),Ren 17 (regulate chest Qi)

Alternative Treatment Methods

auricular – HT, shenmen, chest, LU, subcortex, KI, medium to mild stimulation

7 star – neck, sub-mandibular region, bronchial area, lower sacrum, chosen points from prescription, PC 6, LU 9, etc., medium stimulation- just until spotting blood

injection – BL 15, PC 6, Dan Shen, Dang Gui, Chuan Xiong