Cardiac

[Guest guest]

Thanks for this Phil -

 

Here is more info re congetive heart failure from Cardiologist Zhou Yi Qiu.

 

 

Physical examination

n signs of cardiomegaly

n apical impulse is felt to be enlarged and displaced to the left

n tachycardia

n a diminished first heart sound

n a late diastolic atrial sound (S4 gallop)

n a protodistolic ventricular sound (S3 gallop)

 

 

 

 

 

 

n accentuated pulmonic second sound

n systolic murmurs

n inspiratory basilar rales

n expiratory wheezing and rhonchi

n pulse alternans

n bibasilar dullness to percussion (pleural effusion)

 

Diagnostic studies - EKG

n Sinus tachycardia

n Ventricular hypertrophy

n Myocardial ischemia

n Isolated PVC, complex ventricular arrhythmias

n left bundle branch block

 

Diagnostic studies - Chest radiograph

n Cardiomegaly (cardiothoracic ratio, CTR> 50%)

n left ventricular enlargement

n Interstitial edema, perivascular edema, alveolar edema

n Kerly B lines

n Pleural effusion

 

Diagnostic studies - Echocardiography

n Evaluates the possible primary or secondary causes

 

n Measures Chamber dimensions, valve function. LV hypertrophy,

pericardial effusion, and wall motion abnormalities may be seen.

 

 

n Measures Left ventricular ejection fraction (LVEF, normal > 50%),

cardiac index (CI,

normal range is 2.2-3.5 L/min/m2)

 

 

 

 

Diagnostic studies – Radionuclide ventriculography

Obtained easily even in obese patients, to evaluate:

n Wall motion abnormalities

n Left ventricular ejection fraction(LVEF,normal, 67±8%),

 

n LV hypertrophy and pericardial effusion

 

 

2.1.9. Diagnostic studies - catheterization

n Left-heart catheterization and angiography are necessary with the

presence and extent of CAD

 

n Measures LVEF (normal, 67±8%), diastolic pressure (normal <12mmHg)

 

n Estimates of wall motion abnormalities

 

Heart Qi Deficiency

Clinical outcome:

In the study, Effects of “Shenmai Injectionâ€(SMI) on Plasma Neuropeptide

Y(NPY), Endothelin (ET) and Atria Natriuretic Polypeptide(ANP) in HF Patient,

sixty patients with HF were divided into the treatment group (TG) administered

with SMI combined with western medicine, and the control group (CG)

administered with western medicine only. SMI include Ren Shen and Mai Men Dong,

and

two weeks was a treatment course. The results indicated that the TG was more

effective than CG in improving cardiac function (P<0.05); the plasma NPY, ET

and ANP of both groups were significantly reduced after treatment, the effect

of TG was better than that of CG(P<0.05). SMI not only improved cardiac

function, also regulated the activities of neuroendocrine at the same time.

Phlegm-Damp Attacks the Heart and Lungs

 

 

n Treatment principles:

Drain Lungs, move fluids, and tonify Heart Qi and Spleen Qi.

n Formula: “Ting Li Da Zao Xie Fei Tang†(Descurainia and Jujube

Decoction to Drain the Lungs) combined with “Ling Gui Zhu Gan Tang†(Poria,

Cinnamon Twing, Atractylodis Macrocephalae, and Licorice Decoction)

n Ingredients:

Ting Li Zi (Descurainiae seu Lepidii, Semen) 10g, Da Zao (Zizyphi Jujubae,

Fructus) 10 pieces;

Fu Ling Pi (Poriae Cocos, Cortex) 12g, Gui Zhi (Cinnamomi Cassiae, Ramulus)

9g, Bai Zhu (Atractylodis Macrocephalae, Rhizoma) 10g, Gan Cao (Glycyrrhizae

Uralensis, Radix) 6g

 

 

Phlegm-Damp Attacks the Heart and Lungs

Modifications of herbs treatment:

n For severely reduced urine output, add

Ze Xie (Alismatis Orientalis, Rhizoma) 15 g

Che Qian Zi (Plantaginis, Semen) 15 g

n For severe SOB, nocturnal dyspnea with profuse clear sputum, add

Su Zi (Perillae Frutescentis, Fructus) 9 g

Lai Fu Zi (Raphani Sativi, Semen) 9 g

Bai Jie Zi (Sinapis Albae, Semen) 9 g

 

Will Morris

 

 

 

 

http://tinyurl.com/c5p7p

 

Re herbal Tx, http://www.herbchina2000.com/therapies/ACM.shtml

says:

 

CARDIOMYOPATHY is a weakening of HT muscle (myocardium),

which usually causes inadequate HT pumping; it can be dt viral

infections; HT attacks; alcoholism; long-term, severe hypertension; / for

other reasons not yet known; Cardiomyopathy can be divided into two

types: Systolic failure: low cardiac output, decreased left ventricular

ejection, tendency to accumulate salt & water causing increased

intravascular volume, peripheral dedma, & left & right HT failure

symptoms; Idiopathic, viral, postpartum, alcoholic, & many ischemic

cardiomyopathies may produce systolic failure; An imbalance of

neurohormonal system in norepinephrin causes fluid retention,

peripheral vasoconstriction, & overstimulation of cardiac beta-receptors;

These changes initially allow HT to maintain normal blood flow, but later

cause progressive HT enlargement, lung congestion, & failure of right

side of HT from fluid overload; This inbalance of neuroendocrine system

has led to changes in medical therapy; angiotensin converting enzyme

(ACE) inhibitors are an important part of therapy.

Diastolic failure: normal / super normal systolic function, non-compliant

(stiff) left ventricle w increased filling pressures; Scarring (e.g., post

MI),

amyloidosis, & hypertrophic cardiomyopathy may result in diastolic

failure; Generally, HT is not as enlarged as in systolic failure group.

SYMPTOMS: Shortness of breath; Decreasing ability to tolerate physical

exertion; Chest pain - also known as " angina, " consists of a feeling of

sharp, unrelenting pressure middle of chest (more common in ischemic

cardiomyopathy); Fainting - especially after activity; temporary & brief;

Loss of consciousness; Light-headedness - especially after activity;

dizziness; Palpitations - sensation of feeling HT beat; Hypertension;

Additional symptoms that may occur:; Swelling of legs, ankles, / other

portion of body; Abdomen swelling / enlargement (liquid in abdomen is

called " ascites " ); Low amount of urine during daytime; Need to urinate at

night; Fatigue; Change in mental status; Decreased alertness; Difficulty

concentrating; Cough - may be caused by extra liquid accumulating in

lungs, secondary to HT failure; Loss of appetite; Deconditioning may

occur as a consequence of other symptoms, leading to a reduction in

HT muscle mass. HERBAL TREATMENT Herbal treatment designed to

Boost HT function, improve symptoms, slow disease progression,

prevent & treat HT failure, & most importantly, to boost energy &

strengthen body for better health & quality of life; purpose of herbal

treatment is not to take place of necessary orthodox medical treatment;

Combination of both is a better choice. Excellent Efficacy: During

observations on 12 patients receiving treatment w this herbal

combination, 7 cases were judged as healing (full recovery & symptom

free), 3 cases other significant improvement; Physicians judged clinical

efficacy to be good / excellent in 83.3%.

 

FORMULA has 9 Hbs: Chishao-Rx Paeoniae lactiflorae Rubra;

Chuanxiong-Rz Ligustici; Danggui-Rx Angelicae Sinensis; Danshen-Rx

Salviae Miltiorrhizae; Fuling-Sclerotium Poriae cocos; Honghua-Fl

Carthami tinctorii; Taizishen-Rx Pseudostellariae heterophyllae; Taoren-

S Pruni Persicae; Yanhusuo-Rz Corydalis.