Palpitations
Overview
Palpitations (xinji) refer to a condition in which the patient consciously perceives heart throbbing, with restlessness and a feeling of alarm, sometimes beyond voluntary control. It is often paroxysmal and triggered by emotional disturbance or overexertion. The disease is located in the heart and involves the liver, spleen, kidney, and lung. The basic pathogenesis is deficiency of qi, blood, yin, and yang leading to loss of nourishment of the heart, or obstruction of the heart vessels by phlegm, fluid retention, and blood stasis, resulting in restlessness of the spirit. Pattern differentiation should distinguish deficiency from excess: for deficiency, tonify qi and nourish blood, enrich yin and warm yang; for excess, transform phlegm and eliminate fluid retention, invigorate blood and resolve stasis; for mixed deficiency-excess, treat both the root and the branch.
Pattern differentiation (clinical patterns)
Heart Deficiency with Timidity
Restless palpitations, easily frightened and startled, inability to sit or lie still, scanty sleep with many dreams and easy awakening, poor appetite, thin white coating, and a rapid or deficient wiry pulse.
Calm the fright and stabilize the will; nourish the heart and soothe the spirit.
Heart Blood Insufficiency
Palpitations with shortness of breath, dizziness and blurred vision, insomnia and poor memory, dull complexion, fatigue and lack of strength, poor appetite, pale red tongue with thin white coating, and a fine weak pulse.
Nourish blood and enrich the heart; tonify qi and calm the spirit.
Yin Deficiency with Hyperactive Fire
Palpitations with easy fright, irritability and insomnia, five-center heat, dry mouth and night sweats, worsening with mental strain, accompanied by tinnitus and sore lower back, dizziness, red tongue with scanty fluid and little or no coating, and a fine rapid pulse.
Enrich yin and clear fire; nourish the heart and calm the spirit.
Connections
Daily care & prevention
Maintain emotional stability and avoid fright, anxiety, and excessive worry. Keep a regular daily routine with adequate sleep, avoiding late nights and overwork. Eat a light, easily digestible diet and avoid strong tea, coffee, spirits, and pungent irritants. Perform gentle exercises such as taijiquan and baduanjin to regulate qi and blood. Self-massage Neiguan (PC6) and Shenmen (HT7) for 3–5 minutes each time to calm the heart and soothe the spirit. Seek medical attention promptly if symptoms occur frequently or worsen.
When to seek medical care
If palpitations are accompanied by severe chest pain, profuse cold sweat, pale complexion, cold limbs, or syncope, loss of consciousness, extremely rapid or slow and irregular pulse, or by dyspnea, orthopnea, and coughing pink frothy sputum, this indicates a critical condition requiring immediate emergency treatment.