Exploring Traditional Chinese Medicine for Post-Heart Attack Chest Discomfort

Q: Exploring Traditional Chinese Medicine for Post-Heart Attack Chest Discomfort

Mr. <br>Li： Hello, I am very pleased to receive your letter! Regarding myocardial infarction, you mentioned occasional sharp pain or a feeling of pressure in the center of your chest, and you are seeking advice on traditional Chinese medicine (TCM). <br>I admire your attention to

Regarding chest tightness and pain?

Hello, Doctor.
I have previously asked a question in the cardiology department, and now I would like to seek medical advice regarding traditional Chinese medicine.
To avoid confusion in my inquiry, I will present the treatment process in order, and I hope Dr.
Yang can provide clarification.
1.
Last October, I underwent stent placement (one stent) at a hospital in Keelung due to a myocardial infarction.
2.
In December, to rule out threatening locations, I underwent a second stent placement (three stents).
Everything was normal post-surgery.
3.
In March of this year, I received outpatient care in the traditional Chinese medicine department at the same hospital (while continuing to see the cardiology department without interruption).
4.
At the end of March, I experienced unexplained nosebleeds that did not stop.
The TCM physician adjusted the dosage and prescription three times, but the bleeding continued intermittently, so I suspended the medication until now.
5.
At the end of June, I began to experience occasional sharp pain or pressure in the center of my chest.
6.
In July, the cardiology department arranged for a myocardial perfusion scan, which showed no abnormalities in the heart vessels, and I discontinued one antithrombotic medication, Clopidogrel (as this potent medication could interact with the initial TCM prescription).
7.
In September, I underwent an echocardiogram, a resting electrocardiogram, a 24-hour Holter monitor, and blood tests.
All results were within normal ranges, except for elevated cholesterol levels.
This summarizes my medical process up to now, and I still occasionally experience pressure in the center of my chest.
Although it is not as painful as it was during the surgery, it still causes me considerable concern.
Therefore, I would like to seek further treatment or adjustment through traditional Chinese medicine.
I understand that combining Western and traditional Chinese medicine can be quite challenging, and I also know that certain symptoms may only be detectable when they become more severe.
Rather than waiting for that, perhaps post-operative adjustment could help me manage my condition more safely? My TCM physician initially indicated that I belong to the blood stasis type.
Currently, I am taking enteric-coated aspirin, antihypertensive medication (Candesartan), angina medication (Ranolazine), and cholesterol-lowering medication (Rosuvastatin).
I would greatly appreciate your insights and guidance on this matter.
Thank you.

Li Yuan, 50~59 year old female. Ask Date: 2014/10/23

Dr. Yan Sumei reply Traditional Chinese Medicine

Mr.
Li: Hello, I am very pleased to receive your letter! Regarding myocardial infarction, you mentioned occasional sharp pain or a feeling of pressure in the center of your chest, and you are seeking advice on traditional Chinese medicine (TCM).
I admire your attention to detail and your alertness.
Currently, you are taking enteric-coated aspirin, antihypertensive medication (Candesartan), antianginal medication (Ranolazine), and cholesterol-lowering medication (Rosuvastatin).
It seems you have already received all the necessary treatments and medications.
In terms of TCM, prescribing additional medication can easily overlap with your Western medicine regimen.
The recent nosebleed may have been caused by the aspirin you are taking as an anticoagulant, while TCM may have prescribed blood-activating and stasis-resolving herbs (also anticoagulants).
If you continue to experience occasional sharp pain or pressure in your chest and wish to consult a TCM practitioner, it is important to inform them of the Western medications you are taking to avoid duplication.
Additionally, when taking Chinese herbal medicine, pay close attention to your body's condition; if you experience any discomfort, stop the medication immediately to protect yourself.
As you mentioned, heart issues can sometimes present symptoms that only become apparent when they worsen, making them difficult to diagnose otherwise.
If you wish to combine TCM and Western medicine to address your concerns, it may take time to find the right balance—either resolving the nosebleed without chest discomfort or vice versa.
Fortunately, your carefulness and alertness have served you well.
I encourage you to continue educating yourself about heart disease management, engage in moderate exercise, and seek answers online or consult with a physician when you have questions.
This is my response to you.
I hope you find it satisfactory.
Wishing you all the best!
Sincerely,
Yen Su-Mei, Department of Traditional Chinese Medicine, Nantou Hospital

Reply Date: 2014/10/23

More Info

Exploring Traditional Chinese Medicine (TCM) for post-heart attack chest discomfort is a thoughtful approach, especially considering the complexities of managing cardiovascular health. Your medical history indicates that you have undergone significant interventions, including stent placements due to myocardial infarction, and you are currently on a regimen of Western medications aimed at managing your heart condition.
From a TCM perspective, the concept of "blood stasis" is often discussed in relation to heart health. Blood stasis can lead to symptoms such as chest pain, discomfort, and even emotional distress. In your case, your TCM practitioner has identified you as having a "blood stasis type," which aligns with your experiences of chest discomfort and the history of myocardial infarction.
In TCM, treatment strategies may include herbal medicine, acupuncture, and dietary recommendations aimed at promoting blood circulation, nourishing the heart, and alleviating stasis. For instance, herbs such as Dan Shen (Salvia miltiorrhiza) and Hong Hua (Carthamus tinctorius) are commonly used to invigorate blood flow and reduce stasis. Acupuncture points that correspond to the heart and pericardium meridians may also be targeted to help alleviate discomfort and improve overall heart function.

However, it is crucial to approach TCM with caution, especially since you are currently on anticoagulant therapy (enteric-coated aspirin) and other medications. The interaction between TCM herbs and Western medications can sometimes lead to adverse effects, particularly concerning blood thinning. Therefore, it is essential to communicate openly with both your TCM practitioner and your cardiologist about all the treatments you are considering. This collaborative approach can help ensure that your care is safe and effective.

In addition to TCM, lifestyle modifications play a significant role in heart health. Engaging in moderate physical activity, maintaining a heart-healthy diet low in saturated fats and high in fruits and vegetables, and managing stress through practices such as meditation or tai chi can be beneficial. These lifestyle changes can complement both your Western and TCM treatments, potentially improving your overall well-being.

Given your ongoing symptoms of chest discomfort, it is also advisable to continue monitoring your condition with regular follow-ups with your cardiologist. While your recent tests have shown no significant abnormalities, persistent symptoms warrant further investigation to rule out any underlying issues that may not have been captured in previous assessments.

In summary, exploring TCM for post-heart attack chest discomfort can be a valuable addition to your overall treatment plan, provided it is done with careful consideration of your existing medications and health status. Open communication with your healthcare providers, adherence to prescribed treatments, and lifestyle modifications will be key components in managing your heart health effectively. Always prioritize safety and seek professional guidance when integrating different medical approaches.

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