Traditional Chinese medicine believes that this disease falls under the categories of "palpitation," "severe palpitation," "edema," "heart impediment," and "cough and wheezing." It is often caused by the deficiency of healthy qi in the body, allowing external pathogens to invade and linger, repeatedly attacking and eventually affecting the heart, leading to heart impediment. When the heart is diseased, the circulation of qi and blood becomes obstructed, resulting in qi stagnation and blood stasis. This affects the lung qi's ability to connect with the heart vessels and regulate breathing, causing lung qi congestion and impaired descending function, manifesting as chest tightness, shortness of breath, and coughing. If lung stasis and collateral obstruction occur, leading to chaotic qi and blood counterflow, hemoptysis may occur. If the spleen and kidneys are affected, the qi transformation becomes imbalanced, impairing the transportation and transformation functions, and disrupting water passage regulation, resulting in symptoms such as scanty urine, edema, and severe conditions like water pathogen attacking the heart and lungs.

bubble_chart Modern Research

Wind-dampness valvular heart disease is caused by an allergic reaction due to infection, resulting in valvular damage left by wind-dampness endocarditis. The clinical manifestations include the formation of valvular scars and deformities, leading to valvular stenosis and/or insufficiency, which increases the cardiac load and often results in cardiac insufficiency and arrhythmias.

Modern medicine believes that the pathological changes of wind-dampness heat are connective tissue inflammation, mainly affecting the heart valves and myocardial interstitial small stirred pulse. The pathological process includes the exudative phase, proliferative phase, and scar phase. During wind-dampness carditis, the valves adhere due to inflammatory exudation caused by allergic reactions. This exudate often becomes difficult to absorb due to recurrent wind-dampness activity, gradually forming vegetations, causing valvular fibrosis and adhesion, leading to valvular stenosis and/or insufficiency.

Medical history: A history of recurrent infections and acute wind-dampness fever activity.

Clinical: Mild or early-stage patients may not have obvious subjective symptoms, but most may show symptoms and signs of mitral or aortic valve stenosis or insufficiency.

Laboratory: X-ray chest films, electrocardiograms, echocardiograms, and retrograde aortic angiography are all helpful in confirming the diagnosis of wind-dampness valvular heart disease.

bubble_chart Pattern Analysis

1. Phlegm and Blood Stasis Intermingling︰Severe palpitation, chest tightness with rapid breathing, dark purple complexion, profuse phlegm with cough and wheezing, or even hemoptysis, dizziness, and lack of strength. The tongue appears bluish-purple or with ecchymosis, a greasy coating, and a thin, slippery, rapid pulse or irregularly intermittent pulse. The treatment involves resolving phlegm for resuscitation and dispelling stasis to unblock collaterals. Modified Longstamen Onion Bulb, Trichosanthis Fruit, and Pinellia Decoction combined with Salvia Decoction are used. **Ingredients:** Longstamen Onion Bulb (薤白) 15g, Trichosanthis Fruit (瓜蒌壳) 12g, Pinellia (半夏) 10g, Bitter Orange (枳壳) 12g, Bamboo Shavings (竹茹) 10g, Salvia (丹参) 20g, Sandalwood (檀香) 10g (to be decocted later), Notoginseng Powder (田七粉) 3g (take infused), Cinnamon Twig (桂枝) 10g, Sichuan Lovage Rhizome (川芎) 12g, Liquorice Root (甘草) 5g. **Modifications:** - If chest tightness and discomfort persist, with frequent heart pain or cyanosis of the nails and lips, add Peach Kernel (桃仁) 10g, Carthamus (红花) 10g, Red Peony Root (赤芍) 12g, and Corydalis Tuber (延胡索) 15g. - If symptoms worsen after exertion, add Astragalus (黄芪) 20g, Codonopsis (党参) 15g, and Chinese Angelica (当归) 12g. - If palpitation and restlessness occur, with disturbed sleep and dreamfulness, add raw Fossil Bone (生龙骨) 30g (to be decocted first) and raw Oyster Shell (生牡蛎) 30g (to be decocted first).
2. Heart-Lung Water Flooding︰Chest tightness and palpitations, wheezing cough with shortness of breath, distending pain in the hypochondriac region, profuse white phlegm, or even pink frothy sputum or fresh blood, cyanosis or pallor of the face. The tongue is pale with a white greasy coating, and the pulse is deep and wiry. The treatment principle is to drain the lungs and promote diuresis, calm wheezing, and relieve cough. Modified Pepperweed and Jujube Lung-Draining Decoction is used: Pepperweed Seed 30g, White Mulberry Root-Bark 20g, Chinese Date 7 pieces, roasted Ephedra 10g, Platycodon Root 10g, Bitter Apricot Seed 10g, Cortex Periplocae 10g, Plantain Seed 20g, Alisma 15g. If there is cough, wheezing, and chest fullness preventing lying flat, add Dried Ginger 10g, Asarum 10g, and Pinellia Rhizoma Praeparatum 12g. If there is thirst, scanty urine, and severe constipation, add Fourstamen Stephania Root 15g, raw Rhubarb Rhizoma 15–20g (to be decocted later or infused in water for oral administration), Polyporus 10g, and Areca Peel 12g.
3. Heart Qi Deficiency and Weakness︰Palpitation, severe palpitation occurring intermittently, chest tightness and shortness of breath, worsening after activity or exertion, mental fatigue and lack of strength, profuse phlegm with cough, or even hemoptysis. Pale tongue with a swollen body, thin and weak or irregular pulse. Tonify and replenish heart qi, activate blood circulation and resolve stasis. Modified Celestial Emperor Heart-Tonifying Pill. Astragalus Root 30g, Tangshen 15g, Roasted Milkwort Root 10g, Prepared Liquorice Root 10g, Chinese Angelica 12g, Sichuan Lovage Rhizome 15g, Carthamus 10g, Salvia 15g, Sour Jujube 15g, Poria with Pine 15g, White Atractylodes Rhizome 10g, Submature Bitter Orange 12g. For qi and yin deficiency, add Coastal Glehnia Root 15g, Ophiopogon Tuber 15g, Schisandra Fruit 12g; for yin deficiency with effulgent fire, add Anemarrhena 12g, Phelloendron Bark 10g, Unprocessed Rehmannia Root 12g; for a sensation of emptiness in the heart and severe palpitations, add Cinnamon Twig 10g, Raw Fossil Bone 30g (to be decocted first), Raw Oyster Shell 30g (to be decocted first).
4. Kidney Yang Deficiency︰Dull complexion, wheezing and coughing with rapid breathing, chest tightness and shortness of breath, inability to lie flat, cold hands and feet, palpitations and restlessness, swelling of the face and limbs, scanty urine. The tongue is pale and swollen with tooth marks on the edges, and the pulse is deep, thin, and weak or irregular. Warm yang and promote diuresis, reduce swelling, and relieve wheezing. Modified True Warrior Decoction: Prepared Aconite Root 15g (to be decocted first), Fourstamen Stephania Root 15g, Poria 20g, Cassia Bark 15g, White Atractylodes Rhizome 12g, Astragalus Root 15g, Plantain Herb 15g, Alisma 10g, Areca Peel 12g, Magnolia Bark 12g, Red Ginseng 10g (simmered separately and mixed in), Dried Ginger 10g. If facial and body swelling are present, especially in the lower body, add Polyporus 12g, Common Fenugreek Seed 12g, and Ginger Peel 10g. If palpitations and dark purple lips and tongue are observed, add Salvia 20g, Carthamus 15g, Chinese Angelica 10g, and Sichuan Lovage Rhizome 12g. If kidney fails to receive qi, with worsened wheezing upon exertion, add Tangshen 15g, Prepared Liquorice Root 10g, Schisandra Fruit 20g, and Asiatic Cornelian Cherry Fruit 20g.
5. Spleen-kidney Yang Deficiency︰Mental fatigue, lack of strength, pale complexion, chest tightness, gastric stuffiness, poor appetite, loose stools, abdominal distension or bloating, lower limb edema, scanty urine. Pale tongue with greasy coating, deep wiry thin or knotted and intermittent pulse. Strengthen the spleen and promote diuresis, tonify the kidneys and relieve wheezing. Modified Returning to Spleen Decoction combined with Golden Chamber Kidney Qi Pill. Astragalus Root 80g, Tangshen 15g, White Atractylodes Rhizome 10g, Poria 20g, Chinese Angelica 10g, Prepared Liquorice Root 10g, Prepared Aconite Lateral Root 10g (to be decocted first), Cinnamon Twig 10g, Prepared Rehmannia Root 20g, Asiatic Cornelian Cherry Fruit 15g, Chinese Yam 20g, Alisma 10g. Modifications: For severe edema in the lower body that does not rebound when pressed, add Areca Peel 15g, Magnolia Bark 15g, Akebia Stem 12g; For palpitations and restlessness, add Magnetite 80g (to be decocted first), Sophora 15g.