Coronary heart disease is the abbreviation of coronary atherosclerotic heart disease. The incidence is high in all the countries especially in the developed countries. Recently, the incidence in China is increasing. The risk factors for coronary heart disease are hypertension, hyperlipemia, diabetes mellitus and cigarette-smoking. According to the diagnostic criteria made by WHO, coronary heart disease can be divided into: 1.primary sudden caridiac arrest; 2. angina pectoris; 3. my-0cardiac infarction; 4. heart failure due to coronary heart dis-ease and 5.arrhythmia. In this section, only angina pectoris and myocardiac infarction are described.
Diagnosis in Traditional Chinese Medicine
Angina Pectoris Angina pectoris is caused by trancient myocardial ischemia due to decreased coronary flow, manifest-ed as episodic retrosternal pain, smothering and choking, etc.
1. Overworked angina: A transient attack of chest pain is induced by exertion, heavy meals, exposure to cold, or emo-tion. The typical manifestations are sudden attacks of ret-rosternal constricting oppressive pain or gripping pain. The pain commonly radiates to the left shoulder and left arm, ac-companied with cold sweat. The pain lasts 1- 5 minutes and can be relieved by resting or by placing a nitroglycerin tablet under the tongue. Overworked angina can be divided into in-cipient type, stable type and increscent type. In incipient type the duration of the illness is within one month. In stable type, the state of illness can be stable for a long time. The episodes have a definite regularity. In increscent type both the inci-dence and the severity of the attack increase, indicating the unstableness of the disease.
2. Spontaneous angina: The episodes are not related to exertion. The attack may occur in the recumbent position or during sleep, accompanied with restlessness, fright and hyper-tention. The symptoms persist longer and become more severe which could not be relieved by nitroglycerin.
Variant angina is a special type of angina pectoris. It is considered that the attacks are related to the spasm of the ma-jor one of coronary arteries. Its symptoms are similar to those of spontaneous angina. Many attacks occur cyclically in a day. During the episodes ECG shows ST-segment elevation.
In incipient angina, increscent angina, spontaneous angi-na and variant angina, the state of illness changes rapidly and transforms in a short period. This is a transitional state. Therefore, they are also called unstable angina and patients need to be admitted for treatment.
Differentiation and Treatment of Common Syndromes in Trditional Chinese Medicine
1. Obstruction of the Chest-yang:
Clinical manifestations: Oppressed feeling in the chest, paroxysmal chest pain with palpitation and shortness of breath often brought out by the attack of cold, white greasy fur of the tongue, and taut pulse.
Therapeutic method: Warming up and benefiting the chest-yang to remove obstruction of blood flow in the heart-vessels.
Recipe: Decoction of Trichosanthes, Macrostem and Pinellia with additional ingredients:
Ingredients:
Fructus Trichosanthis 20g
Bulbus Altii Macrostemi 12g
Rhizoma Pinelliae 10g
Ramulus Cinnamomi 10g
Radix Salviae Miltiorrhizae 30g
Pollen Typhae 10g
Faeces Trogopterorum 10g
Administration: All the above drugs are to be decocted in water for oral administration.
