Congestive Heart Failure

CHF is a disease which we read a lot about in the USA, and learn how to treat, but rarely see a patient with it. The other day, a 75 year old man came in complaining of chest pain, heart palpitations, and feeling weakness in the legs. His hands and legs were swollen. He had previously been diagnosed with coronary artery diseases. That day, his pulse was fast at 88BPM. He also had a poor appetite, bitter mouth, and shortness of breath when lying flat. His tongue was very red with a thick yellow fur. This was a classic presentation of CHF and a TCM diagnosis of qi and yin deficiency with phlegm fire.

Although Dr. Wang wanted to warm the heart yang to move the water using the formula ling gui zhu gan tang, she knew that he had too much heat and maybe could not take the large dose of gui zhi. Therefore, she used began the treatment with dan shen yin combined with zeng ye tang to move chest stasis and nourish the yin, adding a little gui zhi to test his ability to handle the herb. When he comes back, it is better, she may increase the dose to warm yang and clear the stasis.