Palpitations in Waves with a Sense of Impending Doom? Don't Panic Yet — Check This Self-Assessment List

[Symptom Self-Assessment]

1. When palpitations strike, do you feel tightness in the chest, shortness of breath, or even a sense of panic as if "you might not make it through the next second"?

2. Do these waves of palpitations tend to occur when you are resting quietly, while actually easing during activity or when you are busy?

3. During episodes, do you experience sweaty palms, chills, or feel restless and uneasy, unable to sit or lie still?

4. Are you easily startled in daily life, with your heart racing at the slightest sound, often accompanied by insomnia or excessive dreaming?

5. Have you undergone examinations such as an electrocardiogram (ECG) or echocardiography that showed no significant abnormalities, yet the palpitations keep recurring?

If you match three or more of the above items, please relax first. This feeling of "palpitations in waves with a sense of impending doom" is often referred to in modern medicine as "panic attack" or "cardiac neurosis." From the perspective of traditional Chinese medicine (TCM), it is often associated with patterns such as "insufficient heart qi," "unsettled heart spirit," or "stagnation of the liver and gallbladder." Next, let us use several common medicinal and edible substances to piece together a framework for understanding this problem from a TCM perspective.

I. Why Does the "Monarch Organ" Behind Palpitations Lose Its Ground?

The heartbeat is the most primitive rhythm of life. In Huangdi Neijing · Suwen · Linglan Midian Lun, Chapter 8, the heart is compared to the "monarch organ," stating: "The heart is the monarch organ; spirit and intelligence emanate from it." This means that the heart, like the sovereign of a state, governs the movement of blood through the vessels and also oversees the mental and conscious activities of a person. When the "monarch" is stable, the blood vessels are harmonious and the mind is clear. When the "monarch" is disturbed or deprived of nourishment, manifestations such as "palpitations" (xinji) or "violent palpitations" (zhengchong) may arise.

Palpitations in waves with a sense of impending doom more closely resemble the category of "fright palpitations" (jingji) in TCM. Their characteristic is not continuous acceleration, but paroxysmal episodes that come and go quickly, like a startled bird. In Yixue Zhengzhuan (Correct Transmission of Medicine), fright palpitations are described as "a sudden feeling of being alarmed, with anxious unease in the heart" — distinct from the persistent palpitations caused by ordinary qi and blood deficiency.

Why would a person suddenly experience such a terrifying sense of impending death? From a TCM theoretical perspective, this is often not due to a single cause. It may be that the heart's own "yang qi" is insufficient — like a weak furnace flame that flickers at the slightest breeze. It may also be that the "heart spirit" lacks a settled abode, with the heart qi floating outward, like a monarch who has left the palace and wanders restlessly outside.

II. Longan Enters the Heart and Spleen, Reinforcing "Constitutional Foundation"

When it comes to daily foods most closely related to palpitations, longan meat (longyan rou) — commonly known as guiyuan — is an indispensable one. Longan meat is warm in nature, sweet in flavor, and enters the heart and spleen meridians. In TCM, sweet flavors can tonify, harmonize, and relax. The heart and spleen are precisely the core pivot for the generation and circulation of qi and blood.

Under what circumstances is longan meat useful? Clinically, a portion of people with episodic palpitations often have a sallow complexion, pale lips and nails, easy fatigue, excessive rumination, accompanied by poor appetite and loose stools. This pattern, from a syndrome differentiation perspective, is mostly related to "dual deficiency of the heart and spleen" — heart blood insufficiency deprives the heart spirit of nourishment; spleen qi weakness leaves no source for generating qi and blood.

Longan meat works precisely through tonifying the heart and spleen, nourishing blood, and calming the spirit to help relieve the feeling of "emptiness in the chest with nothing to hold onto." It acts like a logistics minister, quietly supplying the "monarch" with ample provisions. However, it should be noted that longan meat is warm in nature. If you are prone to dry mouth, mouth ulcers, or dry stools — indicating yin deficiency with vigorous fire or interior excess heat — then consumption should be cautious.

III. Sour Jujube Seeds Restrain Heart Qi, Settling the "Floating Spirit"

Following the thread of medicinal and edible substances, another ingredient closely related to palpitations is sour jujube seed (suanzaoren). Sour jujube seed is neutral in nature, sweet and sour in flavor, and enters the heart, liver, and gallbladder meridians. Its most prominent action is to "nourish the heart, supplement the liver, quiet the spirit, and calm the mind," particularly good at restraining the floating heart qi and bringing the wandering heart spirit back to its rightful place.

From the TCM perspective, one common type of episodic palpitations with a sense of impending doom is "heart and gallbladder qi deficiency." Such individuals are easily startled, indecisive when encountering matters, have shallow sleep and wake easily, and still feel lingering throbbing in the heart after waking. The Shen Shi Zun Sheng Shu records: "When both the heart and gallbladder are timid, one is easily frightened by events." The sour flavor of sour jujube seed is astringent and contracts, precisely matching the pathogenesis of "floating heart spirit and insufficient gallbladder qi."

Interestingly, although sour jujube seed and longan meat both calm the spirit, their emphases differ. Longan meat is more inclined to nourish the blood of the heart and spleen, while sour jujube seed is more inclined to restrain the dissipated heart qi. To use an analogy: longan meat adds water to the pot; sour jujube seed is like adding a seal to the lid, reducing the evaporation of steam. One tonifies and the other constrains; when properly combined, they offer a relatively soothing daily pairing for people with palpitations dominated by deficiency. These ingredients can be cooked together in small amounts in porridge or soup.

IV. Lily Clears Heart Fire, Moistening the "Scorching Dryness"

If the first two medicinal and edible substances target deficiency and impairment, then lily (baihe) addresses a different scenario. Lily is slightly cold in nature, sweet in flavor, and enters the heart and lung meridians. It has the dual actions of nourishing yin and moistening the lungs, as well as clearing the heart and calming the spirit. It is particularly suitable for the type of palpitations accompanied by "restlessness in the heart and inexplicable irritability and heat."

Clinically, some people experience palpitations accompanied by significant vexation, insomnia, heat in the palms and soles, dry mouth and throat, or even a sensation of burning fire in the chest. Such cases often belong to "insufficient heart yin with deficient fire disturbing upward." At this point, the heart spirit is not lacking nourishment but is being disturbed by deficient fire, like a small fire starting around the palace, its smoke filling the air and preventing the monarch from sitting peacefully.

The appearance of lily is like a gentle rain falling on parched ground. It can moisten heart yin, clear and descend deficient fire, and allow the heart spirit to regain a cool and comfortable resting environment. Unlike longan mentioned earlier, lily is cold and cool in nature, making it more suitable for people with red tongue, thin coating, and insufficient fluids, rather than those with a sallow complexion and aversion to cold. If palpitations are compared to a "fire," longan is replenishing disaster relief supplies, sour jujube seed is evacuating the crowd, and lily is directly spraying water on the flames to cool them — the three address entirely different states.

V. Fresh Ginger Warms Heart Yang, Dispersing "Yin Cold Congealing and Stagnating"

Palpitations in waves with a sense of impending doom do not always manifest as deficiency or vexing heat. One type is brought on by "cold." Clinically, some people experience palpitations accompanied by marked chills, cold hands and feet, a cold back, or even a sensation of cold air emanating from the chest. From a TCM perspective, this is mostly related to "heart yang debilitation with yin cold congealing and stagnating."

Fresh ginger (shengjiang), the most common seasoning in the kitchen, is also a capable agent for warming and unblocking heart yang. It is slightly warm in nature, pungent in flavor, and enters the lung, spleen, and stomach meridians. Although it does not directly enter the heart meridian, by warming and activating the yang qi of the spleen and stomach, it can indirectly help to warm and support heart yang. This is like a winter day when the room is bitterly cold — instead of directly baking by the stove, you first melt the frost around the house, and the room naturally becomes warm.

Fresh ginger also pairs ingeniously with the previously mentioned ingredients. If palpitations are accompanied by cold pain in the stomach cavity, poor appetite, or vomiting of clear fluid, a few slices of fresh ginger can be boiled with red dates for drinking. If palpitations worsen after exposure to cold, adding a few more slices of fresh ginger to daily stewed soups can help dispel cold pathogens from the body. It should be clarified that what is discussed here is the "medicinal food" dietary approach, not a therapeutic treatment.

VI. Schisandra Restrains Dissipation, Protecting the "Root of Heart and Kidney"

The final medicinal and edible substance to discuss is schisandra fruit (wuweizi). Schisandra is warm in nature, sour and sweet in flavor, and enters the lung, heart, and kidney meridians. Its position in TCM is distinctive — it can restrain lung qi, nourish kidney water, and quiet the heart spirit, making it especially suitable for palpitations of the "heart-kidney non-interaction" type.

What is heart-kidney non-interaction? In simple terms, the heart belongs to fire and resides in the upper burner; the kidney belongs to water and resides in the lower burner. Under normal conditions, heart fire should descend to warm kidney water, and kidney water should ascend to nourish heart fire, forming a dynamic mutual interplay and balance. Once this balance is broken, insufficient kidney water fails to check heart fire, causing heart fire to flare upward in isolation. This manifests as vexation, insomnia with excessive dreaming, palpitations and anxiety, accompanied by kidney deficiency signs such as soreness and weakness of the lower back and knees, tinnitus, and forgetfulness.

The sour flavor of schisandra can restrain — it both restrains the floating heart fire and secures the dissipated kidney essence, acting like a two-way regulating valve that returns the floating deficient fire to the kidney. This regulatory approach of "leading fire back to its origin" (yin huo gui yuan) is, from a TCM perspective, one way to address episodic palpitations caused by deficient fire disturbing upward. Schisandra can be combined with yin-nourishing ingredients such as wolfberry and mulberry, boiled into a tea substitute, or added in small amounts to stewed soup to make use of its sour, astringent nature.

Connections and Boundaries: Medicinal Foods Do Not Equal the End of Syndrome Differentiation

Among the five ingredients discussed above, longan meat is warm and tonifying, sour jujube seed is astringent and restraining, lily is cooling and moistening, fresh ginger is warm and dispersing, and schisandra is consolidating and astringent — each has its own nature, flavor, meridian entry, and applicable scenarios. They are not isolated from one another; rather, they constitute a syndrome-differentiation spectrum for understanding the symptom of "palpitations in waves with a sense of impending doom" — whether it is deficiency, stagnation, cold, heat, or dissipation all requires careful differentiation.

From the perspective of TCM classics, Zhang Zhongjing wrote in Shanghan Lun · Chapter on Differentiation of Taiyang Disease, Pulse, Evidence and Treatment: "Two or three days after cold damage, if the heart is palpitated and vexed, treat it with Xiao Jian Zhong Tang." This passage reminds us that even in the context of externally contracted cold damage, when "palpitations and vexation" appear, one should pay attention to the supply function of the middle burner (spleen and stomach) rather than treating only the head when the head aches and only the foot when the foot hurts, fixing one's gaze solely on palpitations. This also confirms the TCM holistic view of "treating the root cause of disease."

TCM theory places greater emphasis on individualized regulation tailored to each person. With the same symptom of episodic palpitations and a sense of impending death, some people need to tonify the heart and spleen, some need to clear the heart and moisten dryness, some need to warm and unblock yang qi, and others need to restrain and consolidate — if one blindly follows trends in supplementation without distinguishing, the result may completely backfire. If your symptoms recur frequently or are accompanied by chest pain, fainting, or other manifestations, be sure to first visit a formal medical institution to rule out organic heart disease, and only then consider TCM-based regulation.

References:

1. The original text of Huangdi Neijing · Suwen can be consulted in the TCM Ancient Literature Database: https://tcmdata.cintcm.com/

2. WHO Strategic Document on Traditional Medicine: https://www.who.int/health-topics/traditional-complementary-and-integrative-medicine

3. Official Website of the National Administration of Traditional Chinese Medicine: https://www.satcm.gov.cn/

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