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3-09-10 - How to Palpate for a Heart Attack
The following blog entry is written for my colleagues in Chinese Medicine although patients, friends, and family members may get something out of it as well.
Eighteen months ago I came across the teachings of Dr. Jimmy Wei-Yen Chang who has a unique perspective on interpreting the anatomy of the classic Chinese Pulse. His diagnostic methodology does away with the traditional 29 pulse qualities that are taught in Oriental Medical Schools around the globe, and in its place he has developed a system that encompasses both an eastern and a western medical diagnosis. Although his system is too complex and in depth to describe in a blog, there is a pulse presentation that I have had the unfortunate pleasure of palpating a handful of times.
Dr. Chang calls the pulse a “constrained pulse” and describes it as being “the center of the left Cun position is Wiry, fine, firm and appears with strength.” He goes on to describe the pulse as “feeling like there is a bundle of electric wires (that are thin, straight, tight) within the artery with the tautness of the outside artery varying.” To feel the pulse you need to flatten the artery and feel for a thin, straight tight “wire” inside that cannot be rubbed away. We know from the Traditional Chinese pulse positions that the left Cun position is related to the heart and the same holds true for Jimmy's system. According to Dr. Chang a constrained pulse in the left cun position is an indicator of severe cold in the heart and is a warning sign for Xiong Bi, myocardial infarction, or coronary heart conditions. In other words it is necessary to get the patient to the Emergency Department as fast as possible (note ... do not drive them yourself unless you want the liability). So far in my career I have sent 3 patients to the hospital who had this pulse presentation. One of them ended up having a heart attack while in the hospital, one had evidence of a recent heart attack and one of them had a pulled an intercostal muscle in the left rib cage causing chest pain. Fortunately all 3 patients were able to get the help that they needed to keep their pulses flowing for another day. Of interest the 3rd patient ended up being diagnosed with type 2 Diabetes which upon later inspection of the pulse was also present.
While I am still in the process of learning from Dr. Chang's 30 plus years of clinical experience I am grateful for the information of his that I have been able to assimilate so far. If you are interested in Dr. Chang's method look for his seminars through elotus.org. I hope today's post has given you a very tool that you will never need to use. I end this blog with some information from The American Heart Association that is good for all of us to review.
Heart Attack Warning Signs
Some heart attacks are sudden and intense - the "movie heart attack," where no one doubts what's happening. But most heart attacks start slowly, with mild pain or discomfort. Often people affected aren't sure what's wrong and wait too long before getting help. Here are signs that can mean a heart attack is happening:
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Chest discomfort. Most heart attacks involve discomfort in the center of the chest that lasts more than a few minutes, or that goes away and comes back. It can feel like uncomfortable pressure, squeezing, fullness or pain.
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Discomfort in other areas of the upper body. Symptoms can include pain or discomfort in one or both arms, the back, neck, jaw or stomach.
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Shortness of breath with or without chest discomfort.
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Other signs may include breaking out in a cold sweat, nausea or lightheadedness
As with men, women's most common heart attack symptom is chest pain or discomfort. But women are somewhat more likely than men to experience some of the other common symptoms, particularly shortness of breath, nausea/vomiting, and back or jaw pain.
Learn the signs, but remember this: Even if you're not sure it's a heart attack, have it checked out (tell a doctor about your symptoms). Minutes matter! Fast action can save lives — maybe your own. Don’t wait more than five minutes to call 9-1-1 or your emergency response number.
Calling 9-1-1 is almost always the fastest way to get lifesaving treatment. Emergency medical services (EMS) staff can begin treatment when they arrive - up to an hour sooner than if someone gets to the hospital by car. EMS staff are also trained to revive someone whose heart has stopped. Patients with chest pain who arrive by ambulance usually receive faster treatment at the hospital, too. It is best to call EMS for rapid transport to the emergency room.