Cardiac Arrhythmia, Irregular Heartbeat, Heart Murmur

General

Clinical Manifestations
Treatment Principle
Herb Formulas
Points	Due to Coronary Heart disease or rheumatic Heart disease: PC-6, LIV-4, UB-15

Shao Yang Fu With Congested Fluids

Clinical Manifestations	Alternating chills and fever (chills predominate) or Chills without fever Sensation of irritability in the chest Sweating from the head Fatigue Gastrointestinal weakness Heavy head Neuralgia Epigastric distension Lower abdominal pain Tension around pubic bone Periumbilical pain Urinary difficulty Sinus tachycardia T: Moist C: White and slippery P: Superficial and wiry
Treatment Principle	Disperse Clumping Harmonize the Shao Yang Warm the Interior Dispel Cold
Herb Formulas	Chai Hu Gui Zhi Gan Jiang Tang
Points	GB-41, SJ-5, moxa or moxa needle REN-4, REN-6, REN-8, REN-12, SJ-6, ST-25, ST-36

Shao Yang Fu With Tai Yang

Clinical Manifestations	Joint pain with a crackling sensation Epigastric pain Fatigue Gastrointestinal weakness Headache Heaviness in the head Fever Moderately severe chills Distension beneath the Heart Periumbilical or lower abdominal pain Tenseness around the pubic bone Subcostal pain Epigastric fullness Nausea Mild vomiting Mild thoraco-costal discomfort Costal distress Tension in the rectus abdominus Chest distension Abdominal pain Abdominal distension Constipation Irritability Insomnia Repeated loss of spinal alignment due to muscular tension P: Floating and weak
Treatment Principle	Release the Exterior and muscle layer Harmonize and releases the Shao-Yang Harmonize the Liver, Spleen and Intestines
Herb Formulas	Chai Hu Gui Zhi Tang
Points	To treat the Shao Yang: GB-34, LIV-3, LIV-14, SJ-6 To Treat the Tai Yang: UB-12, GB-20

Shao Yang Fu With Liver Qi Stagnation

Clinical Manifestations	Supraventricular tachycardia Fullness and distention in the chest Irritability Occasional fright palpitations Urinary difficulty Constipation Delirious speech Insomnia Subcardiac distention Palpitations at the abdomen Melancholia Fear Agitation Unsteadiness Tends toward mania and convulsions Tends toward fatigue and clumsiness of limbs Dysuria Excitability Dizziness Anxiety Depression Tinnitus Deafness Profuse expectoration of Phlegm Bitter taste in the mouth Palpitations Pale face Oliguria A sensation of extreme heaviness of the body Fatigue Inability to rotate the trunk Difficulty moving the body T: Red C: Slippery P: Wiry and rapid
Treatment Principle	Harmonize the Shao Yang Sedate and calms the Spirit Regulate Liver Qi
Herb Formulas	Chai Hu Jian Long Gu Mu Li Tang
Points	GB-34, HT-7, LI-11, LIV-3, PC-6, SJ-6, ST-44

Spleen Not Governing Blood

Clinical Manifestations	Sallow or pale complexion Anorexia Four limbs feel tired and heavy Physical and mental exhaustion Abdominal and epigastric distention after eating Maybe acid regurgitation or vomiting Loose or unformed stools Shortness of breath Dizziness Palpitations
Treatment Principle	Benefit Qi Conserve Blood
Herb Formulas	Bu Zhong Yi Qi Tang
Points	DU-20, LI-11, REN-4, SP-1, SP-3, SP-4, SP-10, ST-36, UB-17, UB-20

Spleen Qi And Heart Blood Deficiency

Clinical Manifestations	Palpitations, usually worse at night Insomnia with difficulty falling asleep Much dreaming Easily startled Poor memory Poor concentration Phobias Panic attacks Anxiety Nervousness Fatigue Weakness Low spirits Positional dizziness Blurred vision Floaters Four limbs tired and lethargic Loss of appetite Distention and fullness of the epigastrium and abdomen Loose stools Sallow or pale, lusterless complexion Copious, pale menses Uterine bleeding or Light menstrual flow or Amenorrhea Inability to get or maintain an erection Impotence, worse with fatigue Clammy palms Bruises easily T: Pale C: White P: Thready and weak
Treatment Principle	Reinforce and Benefit the Heart and Spleen Tonify Qi and Blood Calm the Shen
Herb Formulas	Gui Pi Tang Zhi Gan Cao Tang Chinese Patent Medicines: Gui Pi Wan Bai Zi Yang Xin Wan Dang Gui Ji Jing Bu Nao Wan An Shen Bu Nao Wan
Points	HT-5, HT-7, SP-6, ST-36, UB-15, UB-17, UB-20, Yintang With forgetfulness: + DU-20, UB-52 With much dreaming: + UB-42 With anxiety: + DU-19, DU-24 HT-7, REN-4, SP-1, SP-6, ST-36, UB-15, UB-20 DU-19, DU-24, HT-7, REN-4, REN-6, ST-36, UB-15, UB-20, UB-23, Yintang With insomnia: + Anmian With abdominal distention: + ST-25

Heart Blood Stagnation

Clinical Manifestations	Palpitations with severe, sharp chest pain Dark, purplish face and lips Cold extremities Dry throat Dry mouth Spider angiomas Dry skin T: dusky and Dry and may have purple spots or sublingual engorgement P: Choppy or Wiry
Treatment Principle	Invigorate the Blood Resolve Stasis Invigorate Qi
Herb Formulas	Xue Fu Zhu Yu Tang
Points

Heart Fire With Blood And Yin Deficiency

Clinical Manifestations	Insomnia Continuous palpitations A sensation of Heat and irritability in the chest A desire to vomit without result Dream-disturbed sleep Anxiety Tongue ulcers Fidgeting Palpitations Maybe a rancorous disposition Irritability Fear and fright Night sweats Shortness of breath Nausea T: Red or Red tip C: Normal P: Thin and rapid
Treatment Principle	Sedate the Heart Calm the Shen Drain Fire Nourish Yin Relieve palpitations
Herb Formulas	Zhu Sha An Shen Wan
Points

Phlegm-Fire Disturbs The Heart

Clinical Manifestations	Mental agitation Confused thinking Restlessness Vertigo Insomnia Epistaxis Bleeding gums Mouth ulcers Mania Irritability Palpitations Bitter taste in mouth Insomnia Much dreaming Easily startled T: Red or Red tip C: Greasy and yellow P: Slippery, rapid and full and maybe wiry
Treatment Principle	Clear the Heart Break through Phlegm
Herb Formulas	Wen Dan Tang + Ding Zhi Wanmodified Huang Lian Wen Dan Tang
Points	HT-7, PC-5, PC-6, PC-7, PC-8, REN-14, ST-40, UB-15

Heart Qi Deficiency

Clinical Manifestations	Palpitations Arrhythmia Shortness of breath Diminished vocal power No desire to speak Excessive perspiration (in daytime) Symptoms worse after exertion or when tired Facial pallor Fatigue Weakness Suffocating sensation in the chest Cold extremities T: Pale and swollen C: White P: Weak or Big and weak or Intermittent
Treatment Principle	Reinforce and Strengthen Heart Qi
Herb Formulas	Si Jun Zi Tang Bao Yuan Dan Zhi Gan Cao Tang Yang Xin Tang #2 Sheng Mai San Wu Wei Zi Tang With Heart Yin Deficiency: Sheng Mai San
Points	UB-15, HT-7, PC-6, REN-14, REN-17, REN-6, ST-36 :

Heart Qi And Yang Deficiency With Blood Stagnation

Clinical Manifestations	Palpitations Shortness of breath (especially on exertion) Excessive perspiration (in daytime) Symptoms worse after exertion or when tired Facial pallor Fatigue, weakness Suffocating sensation in chest Irregular Heart beat Cold limbs Maybe chills Cyanosis Suffocating sensation in chest Depression Facial pallor Maybe stabbing pain in the anterior region over heart Maybe drawing pain down internal aspect of arm (especially left arm) Maybe pain (in chest and/or arm) T: Pale and swollen C: White P: Weak or Big and weak or Intermittent or Thready and weak or Knotted
Treatment Principle
Herb Formulas	Yi Qi Wang Yang Huo Xue Fa
Points

Heart Qi And Yin Deficiency

Clinical Manifestations	Palpitations Anxiety Apprehension Constant worry Poor concentration Irritability Restless sleep Insomnia Dizziness Emaciation Shortness of breath Constipation Dry mouth and throat Numbness Dry cough Cough with little or no sputum Cough with blood streaked sputum Spontaneous perspiration Night sweats Five Sole Heat due to stress Early menses Restlessness Dry tongue Pale copious menstrual flow Weakness Memory loss Excess dreams Fright Physical and mental fatigue Dry, hard stool Coarse skin Dry throat Weakness A skinny appearance A pale complexion T: Pale and shiny or Red C: Thin and white or None P: Knotted or Intermittent or Minute, forceless and Deficient or Thready and rapid
Treatment Principle	Augment Qi Nourish Yin and Blood Restores the Pulse Calm the Shen
Herb Formulas	Zhi Gan Cao Tang Chinese Patent Medicines: Jian Nao Wan Bai Zi Yang Xin Wan Ding Xin Wan Yang Xin Ning Shen Wan Bu Nan Wan An Shen Bu Xin Wan
Points	DU-19, DU-24, HT-5, HT-6, HT-7, PC-5, PC-6, REN-14, ST-36, UB-15, Yintang For spontaneous sweating: + UB-43 Ear: Shenmen, Subcortex, Spleen, Heart, Sympathetic

Heart Yin Deficiency

Clinical Manifestations	Palpitations Arrhythmia Restlessness Insomnia Tidal fever Poor memory Tinnitus Five sole Heat T: Red C: Little or None and often Dry P: Thin and hard and may be Rapid
Treatment Principle	Nourish Yin Sedate Fire Calm the Shen
Herb Formulas	Bu Yuan Yi Yin Tang Sheng Mai San
Points	GB-20, HT-8, KI-3, KI-10, UB-15, UB-23

Heart Yin And Yang Deficiency With Blood Stagnation

Clinical Manifestations	Palpitations Shortness of breath Excessive perspiration (daytime) Cold limbs Maybe chills Cyanosis Suffocating sensation in chest Depression Facial pallor Irritability Easily startled Insomnia Much dreaming Poor memory Low grade fever Night sweats Five sole heat Restlessness Dry mouth Thirst Dry throat Malar flush Irregular heartbeat Maybe stabbing pain in the anterior region over the Heart Maybe drawing pain down internal aspect of arm (especially left arm) Maybe pain (in chest and/or arm) T: Pale and swollen or Red and dry C: White or Little or None P: Thready and weak or Knotted or Intermittent or Thready and rapid
Treatment Principle	Nourish Heart Yin Tonify Heart Yang Invigorate the Blood Break up Stasis
Herb Formulas	Wang Tong Xue Mei Fa
Points

Heart Yang Deficiency

Clinical Manifestations	Palpitations Arrhythmia Sinus bradycardia Chest pain Shortness of breath Diminished vocal power T: Pale and moist maybe clear bubbles on the surface C: Normal P: Deep and feeble with a possible cotton-like sensation between the skin and wall of the vessel
Treatment Principle	Warn and tonify Yang Calm the Shen
Herb Formulas	Gui Zhi Gan Cao Tang Gui Zhi Gan Cao Long Gu Mu Li Tang modified Yang Xin Tang #2 modified
Points	DU-25, moxa or moxa needle HT-5, HT-7, HT-8, PC-3, PC-4, PC-5, PC-6, PC-7, REN-14, REN-17, SP-6, ST-36, UB-15 Moxa or moxa needle HT-5, HT-7, HT-8, PC-5, PC-6, REN-4, REN-6, REN-17, UB-15

Heart Yang Not Vigorous: Water Qi Insults The Heart

Clinical Manifestations	Palpitations Cardiac arrhythmia Chest and abdominal fullness Vertigo Scanty urine Edema Inability to lie down There may be audible fluid sounds in the abdomen when palpitating T: Pale C: White P: Slippery and maybe deep
Treatment Principle	Warm Yang Transform Fluid
Herb Formulas	Ling Gui Zhu Gan Tang Zhen Wu Tang
Points

Heart Blood Deficiency

Clinical Manifestations	Palpitations Maybe arrhythmia Pale nails Pale lips Pale inner surface of the eyelids Restlessness Insomnia Poor memory Vertigo Numbness T: Pale and dry and maybe thin C: Thin and white P: Thin
Treatment Principle	Nourish the Blood Calm the Shen
Herb Formulas	He Che Da Zao Wan #2 Yang Xin Tang Yang Xin Tang #1
Points

Heart Blood Deficiency With Heart Blood And/Or Liver Qi Stagnation

Clinical Manifestations	Absent-mindedness Frequent feelings of extreme sadness with an urge to cry Inability to control one's emotions Depression Restless sleep May be night sweats Abnormal speech or behavior Disorientation Frequent yawning T: Red C: Scanty P: Small and rapid
Treatment Principle	Nourish the Heart Calm the Shen Harmonize the Middle Jiao Ease tension Tonify Spleen Qi
Herb Formulas	Gan Mai Da Zao Tang
Points

Heart And Lung Qi Deficiency

Clinical Manifestations	Chronic cough with sparse sputum Sputum difficult to expectorate Shortness of breath Spontaneous perspiration Dry mouth and tongue Palpitations with a stifling sensation in chest Fatigue Irritability Thirst Dry throat Insomnia Listless speech T: Red and dry or Pink and dry C: Thin and dry P: Deficient and rapid or Irregular and slow or Thready and deficient or Consistently irregular
Treatment Principle	Augment Qi Clear Heat
Herb Formulas	Sheng Mai San
Points	HT-7, LU-9, REN-17, UB-13, UB-15

Heart And Gall Bladder Qi Deficiency

Clinical Manifestations	Insomnia or frequent waking, often early in the morning Unable to fall back to sleep Dream disturbed sleep Easily frightened or startled Tends to wake up in fright Easily unsettled by seeming trivial events Anxiety Timidity Palpitations Shortness of breath Lethargy Fatigue Depression Spontaneous sweating T: Normal or Pale (chronic or congenital cases may show a deep narrow crack to the tip C: Thin and white P: wiry and thready
Treatment Principle	Strengthen Qi Calm the Shen Alleviate fearfulness
Herb Formulas	Ding Zhi Wan Gui Zhi Jia Long Gu Mu Li Tang An Shen Ding Zhi Tang Chinese Patent Medicines: Bai Zi Yang Xin Wan Ding Xin Wan Yang Xin Ning Shen Wan Bu Nan Wan Jian Nao Wan
Points	GB-40, HT-7, LIV-3, LIV-5, PC-7, REN-15 DU-19, DU-20, DU-24, GB-40, HT-5, HT-7, HT-9, PC-6, REN-14, UB-7, UB-15 Anmian, DU-20, GB-40, HT-7, PC-7, ST-36, UB-7, UB-23, UB-47, UB-52, Yintang

Heart And Kidney Yin Deficiency With Heart Blood Deficiency

Clinical Manifestations	Palpitations Arrhythmia Restlessness Insomnia Tidal fever Poor memory Tinnitus Five sole Heat T: Red C: Little or None and often Dry P: Thin and hard and may be Rapid
Treatment Principle	Nourish Yin Sedate Fire Calm the Shen
Herb Formulas	Bu Yuan Yi Yin Tang Sheng Mai San
Points	GB-20, HT-8, KI-3, KI-10, UB-15, UB-23

Gallbladder-Heart Syndrome

Clinical Manifestations	Pericardial pain Arrhythmia Palpitations Paroxysmal chest pain that may refer to the hypochondrium, back and shoulder Epigastric fullness Restlessness Impaired appetite Bitter taste in the mouth Dry throat Symptoms are aggravated by anger or emotional upset Slight relief after belching T: Reddish C: Greasy white or yellowish P:Taut-tense, pounding and slippery in the Gall Bladder position
Treatment Principle	Relieve the Shao Yang Harmonize the Exterior and Interior Spread Liver Qi Relieve Stagnation Invigorate the Blood Circulate Qi Remove Blood Stagnation
Herb Formulas	Gall Bladder-Heart Syndrome #1
Points

Qi And Yin Deficiency

Clinical Manifestations	Chronic cough or Dry cough Insomnia Night sweats Spontaneous perspiration Weakness Palpitations Shortness of breath Fever Irritability T: Red and dry or Red and swollen C: Little or None P: Thready and weak
Treatment Principle	Tonify Qi Nourish Yin
Herb Formulas	Sheng Mai Yin Wan
Points

Blood Deficiency Due To Uterine Network Vessels (Bao Luo) Failing To Communicate With The Heart

Clinical Manifestations	Palpitations Arrhythmia Symptoms are worse during menstruation T: Pale, dry and possibly dusky C: Normal P: Thready
Treatment Principle	Nourish Blood
Herb Formulas	Xiong Gui Tiao Xue Yin
Points