A 68-year-old female has been experiencing chest tightness and flusteredness for over 3 years. She was previously diagnosed with "coronary heart disease with atrial fibrillation" at a hospital. After treatment, her symptoms slightly improved, but the atrial fibrillation did not resolve. In the past month, her symptoms of dizziness, palpitations, flusteredness, and shortness of breath have worsened, accompanied by chest and epigastric tightness, reduced appetite, and an indescribable discomfort in the chest. These symptoms are particularly severe at night, leading to restless sleep and difficulty lying down. Despite taking Persantin and Digoxin, her symptoms have not alleviated. Her tongue coating is thin, and her pulse is fine and irregular. Upon examination: heart rate 120-130 beats per minute, irregular rhythm. Blood pressure 160/90 mmHg. ECG findings: (1) Atrial fibrillation; (2) ST-T changes. The pattern identification indicates insufficiency of heart yang, uneven heart qi, and lack of nourishment to the heart spirit. The treatment should focus on unblocking yang, setting the heart, and calming the mind, using a modified Cinnamon Twig minus Peony plus Dichroa, Oyster Shell, and Fossil Bone Emergency Decoction. Prescription:
Cinnamon Twig 10g, Dichroa Twig and Leaf 10g, Fossil Bone and Oyster Shell 30g each, Tangshen and Ophiopogon Tuber 15g each, Dried Ginger 3g, Chinese Date 6 pieces, Schisandra Fruit 5g
. After taking 7 doses of the above medication, her chest tightness and flusteredness significantly improved, and her pulse rhythm became more regular. However, she still experiences mild palpitations at night, along with fatigue and shortness of breath. Her tongue coating remains thin, with a pale red color and a swollen tongue. The original treatment method is effective, so she continues with another 7 doses. At the follow-up after 3 weeks, she reports that her palpitations and other symptoms have disappeared, with only slight chest tightness, fatigue, and lack of strength remaining. Her tongue coating is thin, with a purplish hue, and her pulse is fine and weak, occasionally irregular. A repeat ECG shows sinus rhythm and a normal ECG. The medication has been effective, so she continues with the original prescription combined with Prepared Liquorice Decoction for 15 doses to consolidate the treatment.