Palpitations – Xin Ji

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 Diagnosis of Palpitations – this accompanies heart disorders, chronic fatigue, anxiety, etc.

Etiology (causes) of Palpitations :

Primary Causes

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

2. Emotional Stress - causes Liver Qi Stag – impairs Heart function- causing Liver Qi Stag – blood Stagnation – blocks Heart meridian – impairs Heart function-dysfunction of SPulse - damp/phlegm blocks meridian – Spleen can’t produce blood to nourish Heart

3. Chronic Illness-consumes Heart Qi and Yin

Secondary Causes

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

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

3. Epidemic Febrile Disease - Toxic heaTongue - attacks Heart

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

Differentiate Palpitations with:

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

Chinese Medicine Differentiation and Treatment of Palpitations 

Heart Qi Deficiency Heart 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 – Bladder 14, 15 (Heart Yang), Ren 4, 6 (Moxa), Pericardium 6 and Heart 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 – Bladder 14, 15 (Heart Yang), Ren 4, 6 (Moxa), Pericardium 6 and Heart 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 deficiency symptoms Tongue - red, scanty dry coat Pulse - thin, rapid

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

Acupuncture points – Bladder 23, Kidney 3, Heart 7, 6 - 5 centre heaTongue - Kidney 1, Pericardium 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 Bladder 15 and Ren 14, Bladder 20, Stomach 36, Bladder 17 (blood) - loose stool – Stomach 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 Deficiency Palpitations 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 – Bladder 15, Ren 14, Bladder 19, Pericardium 5 (ghost), Heart 7 - timid, edgy, easily scared – Pericardium 7 - spontaneous sweat, shortness of breath – Stomach 36, Kidney 7

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

Turbid Phlegm Stagnation Palpitations 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, Pericardium 6, Ren 17, Bladder 15, Moxa Ren 6, Bladder 17, Spleen 10 - insomnia – Heart 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 Bladder 23 (KI Yang), Spleen 9 (diuresis), Pericardium 6 and Heart 7 (palpitations),Ren 17 (regulate chest Qi)

Alternative Treatment Methods for Palpitations 

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

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

injection Therapy– Bladder 15, Pericardium 6, Dan Shen, Dang Gui, Chuan Xiong