Syndrome differentiation should be focused on the determination of deficiency and excess. The former includes collapse of yang and depletion of qi, deficiency of both qi and yin, and deficiency of both yin and yang; the latter involves toxic heat disturbing the heart, interior stagnation of phlegm and damp, and blockage of heart vessel by blood stasis. So the treatment method is to clear away toxic heat in the heart and yingfen and to reinforce qi and nourish yin. But for different cases, the methods should vary: to promote blood circulation and remove blood stasis for prolonged blockage of blood stasis; to recuperate depleted yang and stop collapse for severe cases with heart yang tending to collapse; to tonify healthy qi and strengthen the body resistance for cases with absence of pathogenic factors and presence of healthy qi deficiency after illness.

Essentials for diagnosis   
(1) History of viral infection, such as upper respiratory tract infection or diarrhea 1-3 weeks prior to the attack.
(2) Newly developed symptoms of palpitation, shortness of breath and chest distress, and signs of arrhythmia, gallop rhythm, low heart sounds and enlarged cardiac dullness area. No history of heart disease.
(3) Laboratory examinations show detachment of virus from the pharynx or feces, 4-time increased ratio of antibody neutral titer of serum Coxsackie virus when compared with the first division of serum (or the ratio of the first antibody titer ≥1 : 640), positive serum anti-cardiac-muscle antibody (1:10), and possible increase of serum GOT, LDH, CPK and its isoenzymes.
(4) ECG shows nonspecific changes of ST segment, flattened, biphasic, or inverted T wave, various arrhythmias, ventricular hypertrophy, prolonged QT segment and low voltage. X-ray may reveal normal heart shadow in localized myocarditis, or enlarged shadow and decreased pulsation in extensive myocarditis or cases complicated by pericarditis, and pulmonary congestion or edema in severe cases. Besides, ultrasound cardiogram and nuclein test are helpful to diagnosis

In TCM, a disease or a symptom might be caused by one pathogenic factor, even two or three pathogenic factors. When diagnosing a disease or a symptom, TCM doctors must follow the principle of "Syndrome Dfferentiation", and then "Suit the Remedy to the Case". In order to gain a more definite and valuable diagnosis, it's important and necessary for the doctor to learn the detailed health information of the patient, including his/her disease duration, age, sex, height, weight, family history, urine, stool, diet, sleep, sweat, energy, mood (emotion), as well as the tongue conditions and the palm conditions, etc. If you would want our expert to create a TCM diagnosis, you're welcome to contact us.