the release of an atheromatous plaque. This is another condition which an acupuncturist is
unlikely to see in its acute stage, except by chance.
Myocardial infarction's main manifestation is a sudden and intense chest pain that may radiate to
the left arm or to the neck, jaw or abdomen. The pain comes at rest. There is severe
breathlessness, sweating, nausea and cyanosis of face, lips and nails. Twenty per cent of cases
are fatal. The patient is restless, the pulse is fine and rapid and the blood pressure is decreased.
The temperature may be raised.
From a Chinese point of view, it corresponds to collapse of Yang.
Hiatus Hernia
This a common condition which acupuncturists are likely to see often in practice. It consists in
the protrusion of the upper part of the stomach through the diaphragm into the thoracic cavity.
This condition can cause chest pain. The pain is directly on the sternum and is elicited by
swallowing or stopping. The pain may radiate to the region under the ribs or the space between
the shoulder-blades. There is also nausea, belching and hiccups.
It is important in practice to differentiate a chest pain of this type from those caused by the heart
or lungs.
Carcinoma of Oesophagus
This is more common in men over 40. It causes a pain on the sternum which is typically
aggravated by swallowing. There is also excessive salivation, poor digestion, debility and loss of
weight. The lymph nodes in the neck may be enlarged.
The causes of chest pain are summarized in Table 13.7Table 13.7.
"Epigastric" indicates pain in the stomach area (Figure 14.1(370)). Although the pain may