Acupunctural treatment of acute ichaemic coronary heart disease

Coronary artery disease (CAD) is one of the major causes of death in the whole world. Angina pectoris and myocardial infarction are expressions of CAD. Angina is a symptom complex that results from myocardial ischemia; most commonly caused by narrowing of the coronary arteries. Angina is usually precipitated by exertion, nevertheless, angina variant may also occur at rest. Symptoms typically resolve within minutes with rest or after taking prescribed antianginal medications. In myocardial infarction (MI) there is a necrosis of the myocardium owing to an inadequate supply of oxygen. The syndrome is usually caused by a sudden and complete, or nearly complete, blockage of at least one major epicardial coronary artery. According to traditional Chinese medicine, the aetiology of those disorders could be deficiency of yin and yang in general, Kidney yang deficiency is not able to warm the yang of zang and could appear deficiency of Heart. There are different ways that lead to deficiency and stagnation of qi ofn Heart. Acupuncture and moxibustión have helped in the recovery of that kind of disease.

Case Study

A 58-years-old male patient with a history of CAD, a myocardial infarction 8 month ago, suffered an acute onset of substernal chest pain during rest, weakness, profuse sweating and coldness of extremities. On physical examination there was pallor of face, lips, blood pressure in 60/40 mm Hg, and pulse deep, filiform, almost imperceptible, irregular, rapid, frequency of 125 par seconds. An electrocardiogram was performed as urgency and ST segment depression in the leads V2, V3, V4 V5, and biphasic T wave abnormalities were founded. While the action to refer immediately the patient to the emergency department was executed, acupuncture was applied. The unbalance was considered as a stagnation of Heart Qi, with sinking of Qi and Deficiency of Kidney Qi.

Treatment

The general strategy was to tonify yang qi and to promote free circulation of qi and blood, relieve the stagnation in zang Heart, and tonify Kidney. Acupuncture was then applied at Neiguan P-6 and Renzhong DU-26, slow manipulation, clock wise, needles during 20 minutes, manipulation each 5 minutes. It was practiced Qigong emission at Shanzhong REN-17, Guanyuan REN-4 and Qihai REN-6.

Result

15 minutes after starting the treatment with at Neiguan P-6 and Renzhong DU-26, the paleness star to disappear, the sweatiness stopped, the temperature became better, he recover from the confusional state and chest pain was then released.  25 minutes later the patient was clinical recovered, the electrocardiogram shows recovery of ST segment, normal T wave, but the blood pressure was 80/40 mm de Hg and the pulse was 120 pulses per minute. In the way to the intensive care unit Qigong was practiced in Tanzong (CV 17) without results on blood pressure or pulse, then the emission was performed at Guanyuan(CV 4), Qihai(CV 6), and 3 minutes later the pulse became 88 per minutes and the blood pressure 120/ 80 mm de Hg. When he was examined at care unit there were not signs or symptoms of acute coronary disease. Two weeks later the patients remains without symptoms and following the recommendation for care the balance of the body.

Comments

In this case acupunctural treatment was performed at the beginning of the intervention, just after the electrocardiogram. The recognition of the unbalance was crucial for the favourable evolution of the patient.  

In this case Neiguan P-6 was consider because his actions as a point of Pericardium Channel, as collateral and because it is the point of opening the extraordinary vessel  Yin wei mai which regulate the interior.