The Heart in TVCM is known as the Monarch of the Zang Fu organs as it is the most important one. It Dominates Blood and the vessels, it houses Shen, controls sweats, and opens into the tongue. Qi flow through the Heart is at its maximum between 11 am and 1 pm. The Heart is associated with Fire and is a Zang or solid organ which belongs to Yin. As the Heart belongs to the Fire element and Yang is typically Excessive which can cause damage to Yin causing a Yin Deficiency in Fire types.

Characteristic of Fire (Heart element)

• Summer
• Heat
• Redness/Red
• South
• Bitter
• Joy/Laughter
• Growth
• Heart, Pericardium, Small Intestine, Triple Heater
• Tongue (the tip) and Speech
• Blood vessels, Circulation, and Complexion
• Sweat, Scorched Body Odor, Walking which Creates Sweat
• Mania and Depression

The Jing of the Heart opens the tongue for speech through the connection of the tongue to Heart via the Interior portion of the Heart Meridian. This causes the Heart to control the appearance of tongue.  Fright is associated with Jing and disturbs the Shen. When Shen is out of control it causes panic, mental disorders, insomnia, and palpitation.

Shen as mentioned previously is housed in the Heart. The Shen is reflected in the outward appearance of the whole body, it provides inner peace, as well as maintains mental activities, memory and sleep. The disruption of Shen many times is caused by Heart Blood Deficiency which may be accompanied with Yin Deficiency or by Excessive Fire. The emotion Joy when in excess can cause Shen to escape the Heart causing mental disorder or the inability to focus. Joy helps the Qi Flow to be smooth and slow which promotes longevity. Both Fright and Joy can also disrupt Qi. 

Heart Qi is the propelling force of Blood which flows in the vessels, which is why Heart dominates the Blood and vessels. When Gu Qi and Qing Qi gather within the chest it promotes the circulatory function of the Heart. The function of Qi is important because without Qi and the movement of Qi the vital functions of the animal’s body will stop. Qi influences all parts of the body and circulation to every system. Having an abundant Qi provides good health and Deficiency of Qi causes diseases. Qi has six functions: transforming, transporting, holding, raising, protecting and warming. Yang Qi or just Yang provides the function of warming along with the functions of Qi. Heart Yang warms the entire cardiovascular system.

When there is Heart Qi Deficiency it could lead to Blood Stagnation or Blood Deficiency. Just as Blood Deficiency can lead to Qi deficiency. This is caused by the relationship between the Heart and Lung. Heart rules Blood while Lung governs Qi, as Qi moves the Blood, Blood then carries Qi. Thus, Qi from the Lung is required to move Blood of the Heart.

Blood Deficiency can be due to Heart Blood Deficiency to Liver Blood Deficiency, and visa versa. The relationship between Heart and Liver is the reason for this. Blood is stored and regulated by Liver. Those with both Heart and Liver Blood Deficiency is called global Blood Deficiency. When the Shen stored in the Heart is disturbed by stress it can cause Liver Qi stagnation as Liver dominates the free and healthy flow Qi and emotions.

The final relationship is between the Heart and Kidney which brings Heart and Heat to full circle. Heart which is the Fire element is the opposite of Kidney which is the Water element. The Heart and Kidney function with a Yin and Yang balance. They support and control each other, providing a cooling and warming system. When the cooling system isn’t function, it causes the Heart Fire to easily become Excessive and it transfer into Pathogenic Heat. If there is no warming system, the Kidney Water becomes Pathogenic Cold.

Imbalance of Yin and Yang causes four types of pathological states, two of which are associated with Heat. Fire and Heat have the similar properties. Fire is extreme Heat while Heat is mild Fire, and both are a Yang pathogenic factors. When Yin is at a normal level, but Yang is elevated it causes Excess Heat/True Heat or Yang Excess. It is caused by the Yin’s inability to counteract the warming properties of Yang. The treatment is to clear Heat or sedate Yang in order to bring Yang’s level back to normal. When Yin is low, and Yang is normal this is known as Yin Deficiency of Deficient Heat/False Heat. In this case Yin is unable to balance Yang’s warming properties. The treatment is nourishing Yin. Having Yin and Yang in balance can prevent diseases.

Hypothetical Case

Species: Canine 
Breed: Doberman Pinscher
Age: 6 years
Gender: N

Clinical Diagnosis (conventional): Dilated Cardiomyopathy
Conventional Indications: Diagnosed 1 week ago with Dilated Cardiomyopathy, Stage III (signs of congestive heart failure).  The patients echo reveals excessive premature ventricular contractions, some in triplets with periods of tachycardia. There is coughing and on original presentation 1 week ago radiographic evidence of pulmonary edema. Patient is receiving pimobendan, enalapril, furosemide and sotalol.
Traditional Indications: Cough, fatigue, exercise intolerance, inappetence (mild), cool limbs and ears, with some warm seeking.  Patient is slightly anxious.  At present there is not an increased respiratory effort. There is some rear limb weakness.
Tongue: Purple
Pulse: Irregularly irregular, Choppy, weaker on the right.
Diagnosis: Heart Blood Stagnation with Kidney Yang Deficiency

Treatment:

• Move Blood
• Stabilize rhythm
• Tonify Kidney Yang, Heart Qi

Acupoints: PC-6, HT-7, KID-3, KID-7, ST-36*, BL-14, BL-15, BL-17, BL-18, BL-23*, GV-14*, Bai-hui*, Shen-shu*, CV-17, CV-14

*moxa acceptable

Chinese Herbal Medicines:

• Compound Dan Shen 0.5g per 10 lbs of body weight PO BID
• Concentrated Zhen Wu Tang 0.5g per 20 lbs of body weight PO BID
  
  
  

Species: Equine
Breed: Holsteiner
Age: 7
Gender: Mare
Conventional Indications: inconsistent performance in advanced dressage competitions recently, more flighty and easily frightened, difficulties focusing and staying on task, owner moved horse to new barn for training
Traditional  Indications: fire constitution, pulses urgent, weaker on the left, tongue tip red and dry
Diagnosis: Heart Yin Deficiency
Treatment: Increase pasture time to allow relaxation, Shen Calmer herbal formula for the duration of training, acupuncture weekly including following points: GV-20, GB-21, HT-7, PC-6, Bai Hui.

Edited by Greg Todd, DVM, CVA and Alex Kintz-Konegger, DVM, CVA, CVTP. Hypotherical Case by Greg Todd, DVM, CVA and Alex Kintz-Konegger, DVM, CVA, CVTP.