Chest and Cardiac Pain
Chest and cardiac pain is pain, discomfort, fullness, or a feeling of oppression affecting the area bounded by the clavicles above and the lower costal margin below. It is a common symptom of cardiac disease, although not all chest pain involves the heart. In addition to pain of cardiac origin, chest pain may reflect disease of the lungs, musculoskeletal or gastrointestinal systems, or the autonomic nervous system, and may have an emotional component.
In Chinese medicine, chest pain has many causes, but the basic mechanism that gives rise to pain is the same in all cases: an impediment to qi and blood circulation. The Chinese name xiong bi literally translates as "chest painful obstruction," with the character for bi being the same as the one used in bi zheng or "painful obstruction syndrome."
The mechanism of an impediment to qi and blood circulation can be deficient or excessive. In the case of deficiency, the problem is weak propulsion of blood, leading to pooling, or yin deficiency, causing increased viscosity and stickiness of blood. In the case of excess, a pathogenic substance blocks the circulation of qi and blood.
In both the West and the East, heart disease is a major cause of death. For many people, the first symptom of a heart attack is pain. With improved education and more sophisticated diagnostic techniques, heart disease can be detected in its early stages, when Chinese medicine is particularly useful.
Heart disease is a major cause of death, so it is important to recognize symptoms of cardiac origin and differentiate them from those arising from other structures. Identifying the source of the pain and understanding the underlying biomedical physiology not only aids in prognosis and provides appropriate lifestyle advice; it also determines the need for other forms of medical intervention.