Qi stagnation and blood stasis type coronary heart disease (Part 1)

The heart, although the centre and driving force behind the body’s blood circulatory system, like any other organ, needs to be perfused with blood for normal functioning through its own coronary circulation system.

Coronary heart disease is a disease caused by the formation of plaque buildup that results in a partial or complete blockage of the heart’s arteries (coronary arteries). When blood flow to the heart is reduced, the heart muscles are prevented from receiving adequate oxygen and nutrients.  

Impeded blood flow through the coronary arteries causes myocardial ischemia and depending on the severity may result in heart attack. 

Singapore is a developed country, but it also faces the challenge of coronary heart disease, which is similar to other developed countries. Coronary heart disease is one of the leading causes of death in Singapore. According to statistics from the Singapore Ministry of Health, 21 people die every day from cardiovascular disease (including heart attack and stroke), and cardiovascular disease is the second leading cause of death in the country, after cancer. It is estimated that about one-third of all deaths are due to heart disease and stroke.

The essence of coronary heart disease is that atherosclerosis aggravates and causes cardiovascular stenosis. When the cardiovascular stenosis exceeds 50%, it becomes coronary heart disease. Patients suffering from coronary heart disease often present symptoms such as chest pain, angina pectoris, palpitations, and shortness of breath.

5 types of coronary heart disease

1. Primary cardiac arrest:

Caused by unstable electrical signals, mostly ventricular fibrillation, failure of resuscitation can lead to sudden death.

2. Angina pectoris

(a) Exercise-induced angina pectoris
(b) Spontaneous angina

3. Myocardial infarction

(a) Acute myocardial infarction 
(b) Chronic myocardial infarction

4. Heart failure in ischemic heart disease

5. Arrhythmia:

the only symptom of ischemic myocardial infarction

The main risk factors for coronary heart disease are lipid metabolic disorders, hypertension, and smoking. Secondary risk factors include obesity, mental stress, family history of coronary heart disease, diabetes and so on.

Syndrome Differentiation and Treatment in Traditional Chinese Medicine

There is no term for coronary heart disease in traditional Chinese medicine, and its clinical manifestations belong to the general categories of chest pain, heartache, real pain, and palpitations. The primary site of the disease is the heart, but the ailment is related to the conditions of the lungs, spleen, liver, and kidneys.

This disease mostly arises out of general weakness but presents aggravated symptoms in the clinical setting. General weakness in this instance refers to deficiency of both Qi and Yin, downregulation of heart Yang characteristics, and depletion of heart-blood; with deficiency of heart Qi and Yin being the most prevalent cause resulting in Qi stagnation and blood stasis as common manifestations.

Heart disease caused by qi stagnation and blood stasis syndrome

Qi stagnation and blood stasis syndrome is a common syndrome in traditional Chinese medicine, which refers to a state of poor circulation of Qi and blood in the body. HuangDi NeiJing “Original plain question” explicitly stated that those with heart disease shall experience chest pain, hypochondriac fullness, hypochondriac pain, interscapular pain, and pain in the medial side of the arm. 

Qi stagnation and blood stasis syndrome may lead to aggravation and even the occurrence of heart disease. According to TCM theory, Qi stagnation and blood stasis can affect the normal functioning of the heart, including cardiac contraction and relaxation, blood supply, etc. Specifically, Qi stagnation and blood stasis can lead to the following:

1) Coronary heart disease:

Coronary heart disease is insufficient blood supply to the heart caused by narrowing or blockage of the coronary arteries. Qi stagnation and blood stasis may lead to the aggravation of coronary artery stenosis or blockage, and then lead to symptoms of coronary heart disease such as angina pectoris or myocardial infarction.

2) Arrhythmia:

Qi stagnation and blood stasis may interfere with the normal activity of the heart and lead to arrhythmia, such as atrial fibrillation and premature ventricular contractions.

3) Heart failure:

Heart failure is the inability of the heart to pump blood effectively, resulting in poor blood circulation. Qi stagnation and blood stasis may affect the systolic and diastolic functions of the heart, thereby aggravating the symptoms of heart failure.

Qi stagnation and blood stasis syndrome is frequently manifested in middle-aged and elderly patients, especially those suffering from chronic diseases.  This is a logical outcome mentioned in the aforementioned paragraphs that blood stasis is founded on the bedrock of generalized weakness caused by long-drawn illnesses.

Blood stasis and heart arteries run through the whole course of the disease. This is consistent with the narrowing or spasm of arterial vessels in modern medicine, which leads to obstruction of blood circulation.

The clinical manifestations are chest tightness and pain, often aggravated by emotional discomfort; severe blood stasis, tingling pain in the chest; stagnation of qi, blood stasis, causing tingling pain in the chest. Red tongue with thin yellow furry layer, stringy or knotted pulse.

TCM Therapeutic method: soothe the liver and regulate qi, activate blood circulation and remove blood stasis and painful collaterals

To improve coronary circulation and myocardial ischemia. 

For heart disease caused by qi stagnation and blood stasis syndrome, traditional Chinese medicine often adopts the methods of regulating qi and blood, promoting blood circulation, and dispelling blood stasis. The specific treatment plan shall take into consideration the specific conditions of the patient, and combine with modern medical treatment methods, such as drug treatment, surgical intervention, etc., in order to improve the symptoms of heart disease and promote recovery. When receiving treatment, it is recommended to seek the guidance of a professional TCM doctor or cardiologist, and conduct detailed consultation and diagnosis with them.

Traditional Chinese prescribed herbal medicine to nourish and invigorate blood, dispel blood stasis, and relieve pain.


  1. Avoid emotional swings that impose on the heart;
  2. Avoid exposing oneself to temperature extremity;
  3. Eat moderate portion sizes, avoid high-caloric, salty, and oily cuisine, and be mindful of one’s body weight 
  4. Maintain work-life balance with moderation in work and rest

For those with mild symptoms or currently, under a cardiac surveillance program, it is recommended to drink on a daily basis a special brew of tea comprising 3 grams of Panax notoginseng to relieve spasms and blood stasis.

Patients are advised to bring along their electrocardiogram (ECG) reports and western Doctors diagnosis if available to combine with traditional Chinese medicine treatment; commonly using Acupuncture and Personalized TCM herbal prescription based on individual condition. Prescribed medicine formula is used to nourish and activate blood, remove blood stasis and relieve pain.

Advice from PULSE Dietitian:


Recommend limiting one’s intake of unhealthy fats (such as deep-fried food, animal fats, skin on poultry, processed meat, butter, etc) and sodium (such as salt, seasonings, gravy, processed food, baked goods, etc), to include healthy fats (such as salmon, tuna, avocado, flaxseeds) and rich fibre foods (such as oats, fruits, vegetables) to protect your heart.  Please call on our dietitian if you wish to learn more about Medical Nutrition Therapy.  PULSE dietitians would be delighted to provide you with a personalized plan that takes into account your medical conditions, dietary and lifestyle habits. 


Dr Looi Mai Leng

Dr Looi Mai Leng

Consultant Physician

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