These three symptoms, tightness in chest, shortness of breath, and chest pain (Angina), often appear at the same time, which was first mentioned in Jin Gui Yao Lue (Essential Prescriptions of the Golden Coffer) by Zhang Zhongjing, a famous herbal physician in the Han Dynasty (206 BC). In this book he offered an insightful view on what causes and how to cure this disease.
Middle-aged and the elderly are susceptible to this condition, characterized as the repeated episodes of discomfort, short duration, oppressive pains on the upper left side of the chest, or even radiating into the back of left shoulder and the passing-through areas of the Heart Meridian of Hand-Shaoyin.
Why do I have chest pain and shortness of breath?
It mainly features paroxysmal oppressive pains behind the sternum or in left chest area, but also presenting heartburn, angina (stabbing or dull), or obscure discomfort. The lasting time can be a few seconds to over fifteen minutes. In the severe cases, it tends to last more than 30 minutes and can not be relieved even after taking drugs or rest, often accompanied with pale complexion, sweating, cold limbs, irregular pulse, or even death in 12 hours after the onset, which are the typical symptoms and signs of an angina pectoris.
From the perspective of Traditional Chinese Medicine (TCM), it is often induced by emotional stimulations, overeating, attack by cold pathogen, and overstrain, or attacked with no obvious predisposing causes, accompanied with frequently with lacking in strength, spontaneous perspiration, palpitation, or even asthma, and irregular pulse.
By the way, modern medicine believes that this condition is closely associated with heart attack, angina, stress, pericarditis, pneumothorax, pneumonia, and asthma, etc.
What to do for this condition in TCM?
In terms of the treatments for cardiac or non-cardiac chest pain in TCM, there are a few common patterns. But mind you, these patterns are for reference only and customized remedies may need according to individual situation. So, the differential diagnosis is the most important part to a successful remedy.
Cold coagulated in heart vessel
The symptoms include sudden angina, or radiating to the back and backache radiating to the heart, or severe pain caused by the cold pathogen, palpitation and panting, feeling cold or chilled all the time, thin white coating, spontaneous cold sweat, and deep taut or abrupt pulse. It tends to attack or aggravate because of a sudden cold weather or catching a cold.
The therapeutic methods should be warming channels for expelling cold and activating blood circulation for dredging arthritic pain.
Common Chinese herbs used are Fu Zi (Prepared Aconite Root), Wu Tou (Radix Aconiti Carmichaeli), Gan Jiang (Dried Ginger Root), Gui Zhi (Cinnamon Twig), Gao Liang Jiang (Galangal Rhizome), Bi Bo (Fructus Piperis Longi), Tan Xiang (Sandalwood), Yan Hu Suo (Corydalis Rhizome), Su He Xiang (Resin of Rose Maloes), and Bing Pian (Borneol).
Qi stagnated in heart
The symptoms include chest pressure, dull pain episodes, unfixed location, constant sighing, attack or aggravation when emotion suppressed, or combined with epigastric distension and depression, relief after belching or farting, thin or thin greasy coating, and thready and stringy pulse.
Methods of treatments are activating qi flowing and harmonizing blood for activating collaterals.
Regular herbs adopted are Chuan Xiong (Szechuan Lovage Root), Yan Hu Suo, Yu Jin (Tumeric Tuber), Jiang Huang (Tumeric Rhizome), Jiang Xiang (Dalbergia Heartwood), Tan Xiang, Dan Shen (Salvia Root), Hong Hua (Safflower Flower), Ju Pi (Tangerine Peel), Qing Mu Xiang (Radix Aristolochiae Recurvilabra), E Zhu (Zedoaria Rhizome), and San Leng (Scirpus Rhizome).
Turbid phlegm obstructing
Main symptoms and signs are heavy oppression but light pain, obesity, excess amount of phlegm, breathing hard, breaking out or worsening during rainy days, often accompanied with languidness, loss of appetite, loose stools, gluey saliva, nausea, white greasy or slippery coating, coughing out mucus, and smooth pulse.
The treating principles should be activating yang, discharging turbid, eliminating phlegm, and resolving masses.
Usual herbs are Gua Lou (Trichosanthes Fruit), Xie Bai (Chive Bulb), Ban Xia (Pinellia Rhizome), Zhi Shi (Immature Bitter Orange), Gui Zhi, Ju Pi, and Sheng Jiang (Fresh Ginger Rhizome).
Blockade of blood stasis
Primary symptoms include stabbing or colic pain, fixed location, or radiating to shoulder and back, coupled with chronic unhealing choking sensation, aggravating due to rage, dark red or dull purple tongue with ecchymosis or dark purple sublingual collateral vessels, thin coating, and slow pulse with irregular intervals, or uneven, intermittent or abrupt pulse.
Therapeutic principles are promoting blood circulation to remove blood stasis and dredging the channels and collaterals.
General herbs are Dan Shen, Chuan Xiong, Tao Ren (Peach Seed), Hong Hua (Safflower Flower), Su Mu (Sappan Wood), Jiang Xiang, Pu Huang (Cattail Pollen), Wu Ling Zhi (Flying Squirrel Feces), Shan Zha (Hawthorn Fruit), Yi Mu Cao (Chinese Motherwort), San Qi or Tian Qi (Pseudoginseng Root), Yu Jin, and Yang Hong Shan (All-grass of Thellung Pimpinella).
Deficient of both qi and blood
And this pattern has three main different classifications as far as shortness of breath and chest pain are concerned.
Deficient heart qi
Major symptoms are dull pain in chest, chest pressure, panting, worsening when exercising, palpitation, languidness, laziness to speak, pale white facial complexion, or pink big fat scalloped tongue with thin white coating, sweating easily, and moderate thready or intermittent pulse.
Rules of treatment are tonifying heart qi and promoting heart pulse.
Prime symptoms are occasional angina, or causalgia, or dull pain, palpitation, five heart irritable heat (heat and irritable sensation in the chest, palms and soles), dry mouth and throat, hot flash and night sweating, red but lustreless tongue with thin or peeled coating, and rapid thready or intermittent pulse.
Therapies are nourishing Yin and clearing heat and nourishing heart for calming the spirit.
Primary symptoms are obvious chest tightness, panting, palpitation, spontaneous perspiration, worsening when exercising, lassitude of the spirit, intolerance of cold, white complexion, pale fat tongue with white greasy coating, cold or swollen limbs, and slow deep thready pulse.
Treatments are tonifying yang qi and warm up heart yang.
Popular herbs are Ren Shen (Ginseng Root), Huang Qi (Astragalus Root), Bai Zhu (Atractylodes White Rhizome), Fu Ling (Poria), Gan Cao (Licorice Root), Mai Men Dong (Ophiopogon Tuber), Wu Wei Zi (Schisandra Seed), Di Huang (Rehmannia), Dang Gui (Dong Quai), Dan Shen, Shan Zha, Hong Hua (Safflower Flower), Jiang Xiang, and Yan Hu Suo.