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Atherosclerosis : Symptoms
Western Medicine Chinese Medicine

The symptoms of atherosclerosis vary depending on where the blockage is. Many people have atherosclerosis without ever experiencing symptoms because the condition has not become severe enough to block any of their blood vessels.

If you are a smoker, are overweight, have diabetes, high blood pressure and/or have family members known to have high cholesterol or high blood fat levels you are at high risk of developing atherosclerosis.

The most commonly blocked vessels are the coronary arteries supplying oxygen to the heart, (a condition often known as coronary heart disease); the carotid arteries and the vertebro-basilar arterial systems which supply oxygenated blood to the brain; the brachial artery supplying oxygen to the arms; and the femoral, popliteal and tibeal arteries of the leg.

If the blockage is in the heart arteries, symptoms include:

Pain: a crushing pain felt in the centre and left side of the chest, sometimes in the jaw and running down the left arm, known as angina.
Depression or anxious feeling
Collapse/loss of consciousness/blackouts
Sudden death (In women, coronary artery disease can be symptomless.)
Pain that is sometimes mistaken for bad indigestion

If the blockage is in the arteries leading to the brain, symptoms include:
Strokes-a sudden loss of brain function often experienced as sudden weakness down one side of the body, confusion, loss of consciousness and loss of the ability to speak.
Transient Ischaemic Attacks (TIA's) or 'mini-strokes, where the patient has symptoms of a stroke but recovers within days or even hours.

If the blockage is in the leg arteries, symptoms include:
Calf pain felt on walking or running that stops when walking or running does. This condition is called claudication.
Cold legs and feet
Pale, dry skin on the legs and feet
Ulcers on the feet and lower legs that look punched out by a hole puncher.
Black toes.

If the blockage is in the arteries supplying the arms, symptoms may include:
Dizziness or even blackouts when raising the arms to do things like hanging out the washing.
Numbness and tingling in the hands
Pale or purple hands and fingers




In TCM, the symptoms of chest pain syndrome depend on the disharmony patterns.

1. Blockage of heart vessels due to a blood stasis pattern
When qi becomes stagnant and blood stasis occurs, the patient feels sharp pain in the chest that stays in one spot because the blood is unable to circulate. (It should be noted that since blood stasis belongs to excessive evils, the pain is sharp. If the problem is due to deficiency, the pain is dull.) . Being classified as a yin evil, blood stasis will cause problems in yin environments, especially nighttime. Therefore, people with this problem usually feel more pain at night. On examination, the tongue appears dull and purple, and the pulse feels choppy and sinking, both of which are signs of blood stasis.

2. Blockage due to a phlegm dampness pattern
An accumulation of unhealthy phlegm dampness constrains the heart yang, making the patient feel an obstructing pain in the chest. As the nearby heart meridian is blocked by the dampness, the pain progresses to the back of the shoulder. Since phlegm dampness is related to disharmony of the spleen, and the spleen rules the four limbs, individuals with this pattern may feel tired and have a heavy feeling in their limbs. They will also have a cough and shortness of breath. On examination, the tongue coating looks greasy and turbid, and the pulse feels smooth.

3. Deficiency of both qi and yin
Qi is essential for pushing or circulating blood throughout the body. Yin properties are closely associated with blood. If qi and yin are deficient, blood flow will be slowed, leading to blood stasis. As a result, these patients experience paroxysmal (sharp, spasmodic) pain, which occurs from time to time. Insufficient yin nourishment of the heart causes it to beat faster and palpitations to occur. The yin deficiency can also result in a relative excess of yang or illusionary yang, which is not a true yang excess because it is caused initially by yin deficiency symptoms. The relative yang excess rises to the head, leading to dizziness and blurred vision. Patients may look pale and fatigued and have difficulty speaking. Shortness of breath due to qi deficiency can also be present. On examination, the tongue appears red with teeth marks, and the pulse feels weak.

4. Deficiency of heart yang
Deficiency of heart yang causes disharmony of qi and blood flow and presents with symptoms of dull chest pain and shortness of breath. If the condition is severe, the pain may even spread to the entire back. Without sufficient heart yang, palpitations and spontaneous sweating will occur since sweat is thought to be the "fluid of the heart". The pain is usually projected to regions along the heart meridian and progresses to the inner side of the upper arm and the armpit. On examination, the tongue looks pale, and the pulse feels frail, sinking and weak.

5. Obstruction of heart yang
Obstruction of heart yang is usually triggered by an attack of cold evils. As a result of the cold attack, the yang qi movement cannot flow smoothly and becomes obstructed, causing pain in the chest. In severe cases, the pain radiates to the whole back and progresses along the heart meridian, affecting the inner side of the upper arm and armpit. After each episode, spontaneous sweating usually occurs. On examination, the tongue has a white coating, and the pulse is sinking and weak. Sometimes it may feel slow.

6. Deficiency of kidney yang
A person with kidney yang deficiency will have cold limbs, an aversion to cold and suffer from loin (waist) pain A kidney deficiency often causes fatigue and frequent urination. As discussed before in the 'Causes' section, a kidney yang deficiency can lead to a deficiency of heart yang, which in turn, results in chest pain.