Silent myocardial ischemia and its Chinese medicine treatment

Tiejun Tang

Silent myocardial ischemia (SMI), also called asymptomatic myocardial ischemia, is the most common manifestation of coronary heart disease. SMI patients do not seek medical attention as often as angina pectoris patients because SMI does not necessarily cause severe chest pains. Hence the necessary diagnostic procedures such as blood tests, ECG and heart scan are left undone. This places SMI patients under a higher risk of experiencing a sudden and possibly fatal cardiac event. Some cases have been diagnosed as myocardial infarction after been sent to hospital, some cause sudden death. If the myocardial ischemic is emerged in the heart, no matter patient felt pain or not, the potential risk is the same. I would like to remind people, SMI is a silent killer!

Asymptomatic mean no symptom literally. But it does not mean patients didn’t have any symptoms at all. Actually it only means no chest pain. Some SMI patients might experience chest tightness, palpitation and short of breath sometimes, especially after exercise. A person experiencing any of the above symptoms should contact their GP.

Traditional Chinese medicine believes most chest pain and palpitation might due to Qi stagnation and/or blood stasis in heart meridian, or heart yang deficiency. From Han dynasty, Zhang Zhong Jing (AD150-219) applied Gualou Xiebai Tang to treat chest pain due to heart yang deficiency. In Qing dynasty, Wang Qingren (1768-1831) used the herbal formula Xuefu Zhuyu Tang or Buyang Huanwu Tang to treat the chest pain and stroke. Scientific research has approved many Chinese herbs and formulas can improve myocardial ischemia through different methods of action in the body (Refer next paper in this blog).

Kaixin capsule is a patent medicine, combining several herbs, especially developed for treating SMI. The formula was developed from one of my tutor Professor Chen Jinghe. In the 1990s’ I spent three years investigating anti-myocardial ischemia mechanism of the Kaixin capsule through laboratory and clinical research. My research results showed that Kaixin capsule can effectively reduce the risk of myocardial ischemia as well as lower the blood lipid levels.   

Wholism is the characteristic of traditional Chinese medicine, thus one herbal formula consists of several herbs in order to address all aspects of each individuals health condition. Each herbal ingredient plays a unique role, and the choice of herbs and dosage is determined on an individual basis.   

Recently I received a question in the internet could a patient with an elevated ST segment in their ECG reading benefit from Chinese herbs. Elevation of a ST segment indicates myocardial infarction. I replied that even though this is an emergency and requires hospital care, Chinese herbs can be used to improve the insufficient coronary artery circulation, and release the tightness or pain in the chest. Chinese herbs can also be used to reduce high blood pressure and to regulate blood lipid levels.

Sometimes ECG still shows ischemic changes after a coronary bypass operation, PTCA or coronary stents accompanied with chest tightness and shortness of breath. This is believed to be related to re-narrowing of a coronary artery. Also these conditions can be treated like SMI in Chinese medicine.

Apart from Chinese herbal medicine acupuncture also shewed a good effect in MI. (Refer: http://www.plosone.org/article/info%3Adoi%2F10.1371%2Fjournal.pone.0094604 )

Be aware of the risks of SMI, take care of your heart, take care your life.