Coronary thrombosis and atherosclerosis Coronary thrombosis and atherosclerosis are concepts adopted from western medicine. Originally Traditional Chinese Medicine (TCM) do not have the same concept. However TCM is evolving and developing, inevitably it must take, recognize and treat this kind of disease. Is this coronary thrombosis and atherosclerosis new to Chinese of TCM? No, TCM have its only categorization method, atherosclerosis was taken as “the stagnation of blood due to over concentration”, whereas Coronary Thrombosis caused by atherosclerosis was taken as “the arthralgia of heart or angina pectoris due to the stagnation of blood”. Since TCM highly valued the basic environment of health, internal organ involved, channel of pathology and take them as the major criteria in the categorization of disease. As coronary thrombosis might have different causes such as dificiency in blood, heat or cold, etc., just coronary thrombosis will not be sufficient for a TCM pratitioner to treat the patient. I have found some explanation from the Concise English-Chinese Medical Dictionary as follows:- Coronary thrombosis - the formation of blood clot (thrombus) in the coronary artery, which obstructs the flow of blood to the heart. This is usually due to atheroma and results in the death (infarction) of part of the heart muscle.  Atherosclerosis - a disease of the arteries in which fatty plagues develop on their inner walls, with eventual obstruction of blood flow (see atheroma). Atheroma - degeneration of the walls of the arteries due to the formation in them of fatty plaques and scar tissue. This limits blood circulation and predispose to thrombosis. It is common in adults in Western countries. A diet rich in animal fats (see cholesterol) and refined sugar, cigarette smoking, obesity, and inactivity are the principal causes It may be symptomless but often causes complications from arterial obstruction in middle and life. (such as angina pectoris, heart attack, stroke and gangrene). We can find the relationship between coronary thrombosis and atherosclerosis as follows:- Atheroslerosis can result in coronary thrombosis and angina pectoris can be the midway. However, this is not an absolute relationship. Apart from atherosclerosis coronary thrombosis can also be a result of blood deficiency, cold or heat. Indeed, a different set of symptoms will be found in the diagnosis process. What is important is that atherosclerosis is not the only cause for angina pectoris or coronary thrombosis or different disease resulted in the problem of blood flow, although atherosclerosis is widely known as the cause of coronary thrombosis. The main points for this kind of problem are heart, blood, blood circulation and thrombus. Heart is usually the position showing the main symptoms and it will be the main battlefield. According to the Eight Principal Syndromes, the heart itself can be differentiated by Yin and Yang; Superficies and Interior; Cold and Hot; Sthenia and Asthenia. Yin problem like thickened liquid in heart influence the flow. Superficies and Interior identify the depth of the problem and guide us on the use of herbs affecting different depth in organ. Both Sthenia (too much) or Asthenia (not enough) can cause heart and blood flow problem. The use of herbs should take all this into consideration. The solution to blood, circulation and thrombus problems mainly focus on the thickness or concentration of blood, the dissolve of blood clot and the activation of blood circulation. Indeed, we must also take care of the situation and condition of the patient and other internal organs for which the treatment will also be based on. Patient usually does not know too much about their body condition. So everything start up with the patient’s own feeling. How he feels? Where is the problem? Any time interval or time factor for the symptoms? The patient suffering from coronary thrombosis due to atherosclerosis usually have angina pectoris at the same time. There are certain cases the patients also suffer from rash and maculae; and other symptoms which can be resulted in poor blood circulation such as arthralgia, numbness, pain and swelling of limbs. There are different symptoms for a disease, indeed, we had to keep our eyes open. In TCM, atherosclerosis can be diagnosis in following aspects:-  Observation – Head is the top and surface of various Yang. Is there any abnormal redness shown on the face and eyes? The Tongue is the orifice of heart - abnormal redness and swelling can be a result of blood concentration whereas peticia can be a result of thrombus. Lip is related to spleen and also related to blood – simply appearance can also rectify the same conclusion in blood. Any rash and maculae found on limbs and body can also regarded as a result of poor blood circulation and blood concentration. Inguiry – The patients own feeling – any pain on the position near the heart? Any previous history related? Any sport or severe exercise before the symptoms? The menu of food before the symptoms? The eating habit, this can be traced to a relatively longer time for full understanding? Smoking habit? We can refer to the Western explanation of atheroma, “. . . A diet rich in animal fats (see cholesterol) and refined sugar, cigarette smoking, obesity, and inactivity are the principal causes. . .” Pulse examination – As mentioned before, there can be various symptoms for any given disease whereas any given patient can be suffering from various diseases at the same time. The pulse appearance will have different appearance and special point at the same time. However, we can say the main point related to our topic and blood circulation and heart. For poor blood circulation, we usually find an Uneven Pulse or in Chinese (澀脈) this indicate the unevenness in blood flow. Rapid Pulse or in Chinese (數脈) indicate the heat in heart and the dryness of Yin (body fluid including blood). Other kind of Pulse can also be found but the emphasis will be surrounding the position related to heart and blood so the Left Cun pulse (左寸) related to heart; Left Guan pulse (左關) related to liver; both Chi pulse (兩尺) related to kidney and right Guan (右關) related to Spleen and stomach so attention should also be paid on them. Treatment can be made under four different topics namely: Herbs; Acupuncture; Food and Drink; Lifestyle and exercise. Herbs are usually used to achieve four main objectives: 1. Dilute the blood concentration 2. Increase the fluid in blood 3. Activate the blood flow 4. Dissolving the blood clot. Commonly used herbs are:- 丹參 root of red rooted salvia (Radix Salviae Miltiorrhizae) cool the heart; activate the blood in heart; disperse blood stasis and relief pain. 生地 fresh or dried root of rehmannia (Radix Rehmania) cool the heart ; cool the blood; increase the fluid in blood and dilute blood concentration; nourish yin. 三棱 burreed (rhizome) (Rhizoma Sparganli) mild warm; activate blood flow. 莪朮 zedoary turmeric (zhizome) (Zhizoma Zedoariae) mild warm; activate the flow of zhi or vital energy. 山楂 fruit of hawthorn (Fruitus Crataegi) disperse blood stasis; dissolve blood clot. 三七 root of pseudo-ginseng (Radix Notoginseng) disperse blood stasis; dissolve blood clot. Apart from the above, herbs should also be used according to the outcome of the eight syndromes to balance the condition of heart so as to provide a suitable environment for general health. Indeed, the determination of treatment should be based on the differentiation of signs and symptoms and general body condition. While herbs collection are subject to individual preference. Acupuncturist can tailer make their plan according to the patients condition. However, according to my personal experience blood donation in safe condition accompanied with herbs which dillute and increase the fluid in blood accompanied with herb activating blood flow can be taken as an effective treatment to atherosclerosis. Food and drink, balanced diet and the main condition for physical health. The patient suffering from coronary thrombosis due to atherosclerosis of should be managed with even tight guidance. Meat and food composing of high animal fat should be avoided or controlled. Internal organ of animal should be prohibited. Stop smoking and low sugar. More fiber rich and Low fat / Low sugar / fluid rich cereal and fruit should be taken as replacement. Lifestyle and exercise – regular exercise and rest is necessary. Avoid prolonged exposure to extreme cold and heat. Control body weight and avoid obesity. Avoid excessive emotional stress. The best treatment is by prevention. The first step of prevention is recognizing your body, the disease and their cause. Hope this can help.