Cardiac+Arrhythmia

Western Diagnosis Abnormalities in the normal rhythmic contraction of the heart

A. palpitations: awareness of the heartbeat

B. hemodynamic upset --sustained bradycardias or tachycardias --serious, possibly life threatening --dizziness, syncope

Diagnosis
1. hx 2. peripheral pulses 3. jugular venous pulse 4. ECG 5. Holter 24 hour ECG monitoring

Treatment
1. reassurance --most arrhythmias benign --must determine severity and type 2. drug tx [digitalis is some types, Beta-blockers occasionally used] 3. food sensitivities

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Definition:
Abnormal heart rhythm. Normal sinus rhythm originates within the pacemaker cells of the sinoatrial (SA) node at the junction of the superior vena cava and high right atrium. These cells represent the primary electrical generator (pacemaker) for the normal human heart. The impulse generated here travels to the atrioventricular (AV) node, thence to the rest of the myocardium. Conduction of impulses is a complicated series of events; all of the conductive tissues and nodes of the heart contain cells capable of spontaneous depolarization. Cardiac arrhythmias generally represent other tissues assuming the role of pacemaker. There are often complications.

Etiology:
Arrhythmias can be the result of damaged conductive tissue in the heart being placed under stress. Causes of arrhythmias are diverse, and include coronary artery disease, hypertension, drug reactions, endocrine abnormalities, myocardial disease, rheumatic fever, metabolic derangements etc. The type of arrhythmia may point to a particular cause.

Somatic Therapies:
• breathing exercises • qigong

Nutrition:
therapeutic foods: • foods that tonify the Heart, Five Phases, foods rich in Magnesium and Potassium, Hawthorne berries

fresh juices: • carrot (Walker, p. 140) • carrot and spinach (Walker, p. 140) • carrot, cucumber, and beet (Walker, p. 140)

avoid: • fruit (Zeff)

Botanicals
• Anemone pulsatilla (toxic): sense of danger (often associated with functional disorders) increases power and regulates action of the heart (Felter and Lloyd, pp. 1589, 1591) • Crataegus oxyacantha: rapid, feeble heart action, cardiotonic (Felter, p. 326) • Convallaria majalis (toxic): irregularity due to mechanical impediment, palpitation and vehement heart action, dyspnea: according to dose. See Felter and Lloyd, pp. 597-598 (British Herbal Pharmacopoeia, p. 74) • Cytisus scoparius: (see Weiss, p. 150) • Digitalis purpurea (toxic): weak, rapid, irregular heart action with low arterial tension (Felter, p. 333) • Gelsemium sempervirens (toxic): cardiac sedative (Weiss, p. 151l; Ellingwood, p. 74) • Kalmia latifolia (toxic): cardiac palpitation reflex from gastrointestinal irritation (Felter, p. 440) • Lycopus virginicus: heart disease characterized by irritability, irregularity, with dyspnea and precordial oppression; increases contraction (Felter and Lloyd, p. 1215) • Rauwolfia serpentina (toxic): extracted alkaloid: contraindications. See Weiss, p. 1515 • Selenicereus grandiflorus (toxic): of nervous origin, irregular pulse, feeble heart action, violent heart action, sense of constriction or a band around the heart or chest (Ellingwood, p. 213) • Strophanthus hispidus: rapid feeble heart (Ellingwood, p. 221) • Trillium pendulum (toxic): assists heart remedies in relieving functional irritation (Ellingwood, p. 263) • Viscum flavescens (toxic) (Felter and Lloyd, p. 2081)

Chinese Formulae
• Baked Licorice C. (Zhi Gan Cao Tang): Heart Qi Xu (Deficiency) and Heart Xue Xu (Blood Deficiency), Shen Disturbance: insomnia, anxiety, constipation; knotted or consistently irregular pulse (Yeung, p. 134, Hsu, 1980, p. 529; Bensky and Barolet, p. 257) • Sheng Mai San: Lung Qi Xu (Deficiency) and Yin Xu (Deficiency): spontaneous sweating (Yeung, p. 207; Bensky and Barolet, p. 245) • Suan Zhao Ren Tang; Zizyphus 18 (patent); Tian Wang Bu Xin Dan (Tien Wang Pu Hsin Tan) (patent): Kidney Yin Xu (Deficiency) and Heart Yin Xu (Deficiency) (Fratkin, p. 229; Dharmananda, 1986, p. 29) • Stephania and Ginseng C.: Qi Stagnation, Water Stagnation in the chest; valvular disease (Hsu, 1980, p. 500) • Ginseng and Longan C. (Gui Pi Tang): Spleen Qi Xu (Deficiency): supraventricular tachycardia (Hsu, 1980, p. 425; Yeung, p. 112; Dharmananda, 1986, p. 244; Bensky and Barolet, p. 255) • Hoelen, Licorice and Jujube C.: Spleen Yang Xu (Deficiency) causing Heart Misted by Cold Phlegm; neurotic palpitations (Hsu, 1980, p. 495; Dharmananda, 1986, p. 110) • Pinellia and Magnolia C. (Ban Xia Hou Po Tang): Liver Qi Stagnation causing Phlegm: plumpit Qi, stifling sensation in chest (Hsu, 1980, p. 395; Yeung, p. 42; Dharmananda, 1986, p. 226; Bensky and Barolet, p. 291)

Acupuncture
after assessing the person and palpating, consider these patterns: Heart Qi Xu (Deficiency) and Heart Xue Xu (Blood Deficiency); Shen Disturbance; Lung Qi Xu (Deficiency) and Yin Xu (Deficiency); Qi Stagnation; Water Stagnation in the chest; Spleen Qi Xu (Deficiency); Spleen Yang Xu (Deficiency) causing Heart Misted by Cold Phlegm; Liver Qi Stagnation causing Phlegm

» illustrative combinations: • UB-15, Ht-7, PC-6 and GB-34; joined to Sp-9 for cardiac arrhythmia (Shanghai, p. 253) • Ht-5 and UB-15 for cardiac arrhythmia (Shanghai, p. 252) • Ht-5, Ht-8, PC-6 and PC-7 for cardiac arrhythmia (Shanghai, p. 254) • GV-9 and PC-6 for cardiac arrhythmia (Shanghai, p. 203) • GB-34 -> Sp-9: transform Damp-Heat

Homeopathy
• Aconitum napellus: fear, hypertrophy of heart, feeling of constriction, angina • Argentum nitricum: great nervousness with all complaints; nausea, claustrophobia; < lying right side • Calcarea carbonica: during fever, from anxiety, after exertion, after eating, from sexual excitement, after suppressed eruptions • Coca: palpitation and dyspnea; headache with vertigo preceded by flashes of light • Colchicum: structural changes in heart with added anxiety; nervous irritation, ascites • Digitalis: after coition, from anxiety, after exertion, atrial fibrillation or flutter, affection of mitral valve • Gelsemium: sensation heart would stop beating if patient did not move • Glonoinum: with hypertension, before convulsion, nervous irritation, from climacteric; atrial flutter • Lycopodium: at night, after eating, during digestion • Naja: after exertion, nervous irritation; valvular affections with anxiety • Natrum muriaticum: during pregnancy, hysterical, anxiety, fear or fright, anemia, during cough, after exertion • Pancreas 6x: anxiety < after sweets or after not eating for a while; butterflies in the stomach, palpitations, feeling of pressure in the chest; very excitable (Burke) • Phosphoric acid: after sexual excitement, during coition, from grief; palpitation in children who grow too fast

Subtle Support
• notes: A, A#, B, C, C#, D, D#, E, F#, G, G#

• chords: dominant 7th, diminished 7th, A Major, A# Major, C Major, G Major, G# Major (Gimbel, p. 116)

cardiovascular: • The Barcarole • The Blue Danube • Chopin's A minor Waltz • Tango music • Humoresque • Cui's Orientale • Song of India • Donna e Mobile • Oley Speak's Sylvia (Heline, p. 18)

Mind/Body
• associated with anxiety and grief (Epstein, p. 77) • associated with severe psychological disturbances in the twenty-four hours preceding the arrhythmic episodes (Gentry, p. 47) • The heart represents center of love and security. (Hay, 1984, p. 168) • In a sample of 225 coronary care patients it was observed that significant reduction in ventricular arrhythmias occurred following pulse palpation. These data suggest that significant changes in arrhythmia can occur as a result of psychosocial interactions. Psychological-emotional factors can significantly influence and alter the incidence of cardiac arrhythmia. (Locke, 1985, p. 95) • Psychologic and neurophysiologic factors (i.e., psychophysiologic stress) may predispose to life threatening cardiac disease in the absence of organic heart disease. (Locke, 1985, p. 87) • The heartbeat comes to our conscious attention only when something is exciting us or when deep changes are afoot. Heart symptoms force us to 'listen to our hearts' once again, and heart patients are people who only want to listen with their heads, and in whose lives the heart figures far too little. They live in the entirely valid fear that their hearts will one day stop and leave them 'heartless.' (Dethlefsen, p. 200)

• Heart ~ Xin houses the Shen (Spirit) and reveals itself through the brightness in the eyes; rules the Xue (Blood) and its vessels and directs the circulation; and relates to the integration of the organs and the personality. » Healthy expressions are warmth, vitality, excitement, inner peace, love, and joy. » Heart Xu (Deficiency) signs include sadness; absence of laughter; depression; fear; anxiety; shortness of breath (Seem, p. 28); cold feeling in the chest and limbs; palpitations; cold sweat; inability to speak; memory failure; nocturnal emissions; and restless sleep. » The Heart is the Emperor of the bodily realm so that when the Heart is disturbed all the other organs will be disrupted.
 * Chinese psychophysiology:**

• Lung ~ Fei governs the Qi; regulates the rhythm of respiration, the pulse, and all bodily processes; is the home of the Po (Corporeal Soul); and relates to strength and sustainability. » Healthy expressions are righteousness and courage. » dysfunction, and illness associated with excessive grief, sadness, worry, and depression. » Lung Xu (Deficiency) signs include cold shoulder and back; changing complexion; inability to sleep (Seem, p. 28); shortness of breath; changes in urine color; rumbling in the bowels with loose bowel movements; pallor; malar flush; chills; sniffles; sneezing; light cough; and sensitivity to cold.

• Liver ~ Gan is the residence of the Hun (Ethereal Soul); it relates to decisiveness, control, and the principle of emergence; stores and cleanses the Xue (Blood); maintains smooth flow of Qi and Xue (Blood); controls the muscles, especially their contractility; reflects emotional harmony and movement; and expresses itself in the nervous system. » Healthy expressions are kindness, spontaneity, and ease of movement. » Liver Xu (Deficiency) signs include impotence; frigidity; pain in thighs, pelvic region, and throat; ready tendency to "the blahs" (Seem, p. 28); timidity; depression; irritability; vertigo; pruritus; dry skin and/or tendons; asthma; aching at the waist; hernia; and difficulty raising head up and down. » Liver Qi Stagnation reflects and accentuates emotional constraint as the Liver's function of facilitating smooth flow in the body is constricted. Stagnation is associated with frustration, irritability, tension, and feeling stuck. With time this pattern tends to produce a gloomy emotional state of constant resentment, repressed anger or depression, along with tightness in the chest, frequent sighing, abdominal tension or distension, and/or a feeling of a lump in the throat with difficulty in swallowing. (Maciocia, p. 216)

• Spleen ~ Pi governs digestion and manifests in the muscles; transforms food into Qi and Xue (Blood); resolves Phlegm; governs the Xue (Blood); and relates to the ability to assimilate, stabilize, and feel balanced and centered. » Healthy expressions are fairness, openness, deep thinking, and reminiscence. » Spleen Xu (Deficiency) signs include slightness (deficient "form"); abundant elimination; morning fatigue; cold, wet feet (Seem, p. 28); abdomen taut and distended like a drum; craving for sweets; flatulence; nausea; mild edema; memory failure; heavy feeling in legs; easy bruising; pale lips; loose stools; muscular weakness; and, indirectly, obesity. » The excessive use of the mind in thinking, studying, concentrating, and memorizing over a long period of time tends to weaken the Spleen and may lead to Xue Yu (Blood Stasis). This also includes excessive pensiveness and constant brooding. (Maciocia, p. 241) Likewise, inadequate physical exercise and excess consumption of sweet and/or Cold foods will also deplete the Spleen. Environmentally, the Spleen is highly susceptible to attack from external Dampness and Cold.

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============================================================= =Potential Contributing Factors= Accompanying affect of weak extracellular calcium ion concentration