Chronic Heart Failure
Overview
Chronic heart failure falls under the TCM categories of 'zheng chong' (palpitations), 'edema', and 'chuan zheng' (dyspnea). Its main symptoms include palpitations, shortness of breath, fatigue, exertional dyspnea, and lower limb edema. The disease is located in the heart and involves the lung, spleen, kidney, and liver. The basic pathogenesis is root deficiency and branch excess: heart qi and yang deficiency as the root, and blood stasis and water retention as the branch. Common patterns include qi deficiency with blood stasis, yang deficiency with water flooding, and qi-yin deficiency. The condition is chronic and recurrent, and prognosis is closely related to pattern type and care.
Pattern differentiation (clinical patterns)
Qi Deficiency with Blood Stasis
Palpitations, shortness of breath, fatigue, exertional dyspnea, chest tightness and pain, dim complexion, cyanotic lips and nails, dark purple tongue with ecchymosis, and a deep choppy or irregular pulse.
Benefit qi and invigorate blood; unblock the vessels and nourish the heart.
Yang Deficiency with Water Flooding
Palpitations and dyspnea aggravated by exertion, aversion to cold with cold limbs, pitting edema of the lower limbs, scanty urine, pale and puffy complexion, pale swollen tongue with teeth marks and white slippery coating, and a deep fine pulse.
Warm yang and promote diuresis, calm the heart and relieve wheezing.
Qi and Yin Deficiency
Palpitations, shortness of breath, fatigue, dry mouth and throat, five-center heat, night sweats, insomnia and dream-disturbed sleep, red tongue with little coating, and a fine rapid or irregular pulse.
Tonify qi and nourish yin, restore the pulse and calm the spirit
Connections
Daily care & prevention
Ensure rest and avoid fatigue and emotional stress; follow a low-salt diet and control fluid intake; engage in moderate exercise such as ba duan jin and tai chi; monitor body weight and urine output; take medications as prescribed and attend regular follow-ups; keep warm and prevent external contractions.
When to seek medical care
Seek immediate medical attention if orthopnea, pink frothy sputum, severe chest pain, confusion, sudden decrease in urine output, rapidly worsening lower limb edema, or significant short-term weight gain occurs.