Chest pain is treated with great vigilance in modern medicine. In particular, angina pectoris is chest pain that occurs when the blood supply to the myocardium becomes temporarily deficient. It is much like the heart crying out that it is struggling because it cannot get enough oxygen. What the Donguibogam calls a blockage in the circulation of qi and blood corresponds closely in modern medicine to coronary artery stenosis. Blood flow problems develop when the coronary artery, which supplies nutrients and oxygen to the myocardium, narrows or becomes blocked due to atherosclerosis.
Atherosclerosis is a condition where plaque, a buildup of cholesterol and fatty deposits on the vascular endothelium, causes the blood vessels to harden and narrow. As plaque accumulates, the elasticity of the blood vessels decreases and the space for blood flow shrinks. Consequently, when the heart needs to work harder—such as during exercise, under stress, or with exposure to cold weather—it fails to receive sufficient oxygen, resulting in chest pain. The pain primarily appears in the center or left side of the chest and is often described as a squeezing, crushing pressure or a heavy sensation. At times, the pain radiates to the shoulders, arms, neck, or jaw.
Angina pectoris is broadly divided into three types. Stable angina occurs during predictable activities, such as climbing stairs, and typically subsides with rest. Unstable angina occurs even at rest, or presents with increasing frequency or intensity; it is considered an emergency because of the high risk of progressing to myocardial infarction. Lastly, variant angina is caused by a temporary convulsion of the coronary artery and tends to occur mainly at dawn or in the early morning.
Major risk factors for angina pectoris include hypertension, diabetes, hyperlipidemia, obesity, smoking, family history, and stress. The concept of blood stasis in the Donguibogam can be understood in a similar vein to atherosclerosis and subsequent thrombus formation that obstructs blood flow. Phlegm-fluid can be seen in connection with inflammatory responses or vascular plaque formation driven by metabolic waste accumulation, while qi stagnation aligns with situations where the stress response hyperactivates the sympathetic nerve, causing vasoconstriction, elevating blood pressure, and placing an added burden on the heart.
If chest pain occurs, it must never be taken lightly. It is crucial to be examined by medical professionals to receive an accurate diagnosis and appropriate care. Because the heart is directly tied to life itself, being attentive to small signals and responding promptly is essential.
