A Case in which Roasted Licorice Decoction Proved Markedly Effective in a Patient with Arrhythmia

Introduction Arrhythmia is a medical condition that manifests as irregularities in the heart rhythm. It involves abnormal pulse rate and abnormal or irregular signal transmission. It is common for the patient to be aware of arrhythmia when it occurs, and for the irregular or intermittent beat to be detectable when taking the pulse at the radial artery, etc. However, there are also cases in which this condition involves other symptoms apparently unrelated to the pulse, such as chest pain or dizziness. When the patient is subjectively aware of palpitations, a characteristic symptom of arrhythmia, this awareness is most commonly experienced at the heart, on the left side of the chest, and sometimes in the abdomen. In some cases the condition is asymptomatic. On ECG, tachycardiac arrhythmia includes extrasystole, tachycardia, and atrial fibrillation, while bradycardiac arrhythmia includes sick sinus syndrome and atrioventricular block. Among these conditions, treatment with Kampo medicine is currently used in cases in which there is symptomatic arrhythmia and the patient is subjectively aware of palpitations. In particular, Kampo medicine is the first choice for the treatment of patients who are subjectively aware of their heartbeat or complain of palpitations, and without abnormal ECG. Western medicine generally receives priority if the ECG is abnormal. Recently we had a case in which ECG findings were abnormal and Western drug therapy was initiated, but treatment was discontinued because of adverse drug reactions. The patient was then switched to a Kampo medication, and arrhythmia was reduced. Our findings are reported below. Patient: 63-year-old man Occupation: farmer Past history: hyperlipidemia Familial history: Unremarkable Present history: In March 1993 the patient developed chest pain unrelated to exertion. He came to the hospital for extensive cardiovascular examination. In addition to chest pain, the patient reported symptoms of occasional palpitations and of tiring rather easily. Chest x-ray and ECG findings were normal. Echocardiogram showed slight calcification of the aortic valve, but no other abnormal findings. Holter ECG recordings showed supraventricular extrasystoles (Fig. 1) and ventricular extrasystoles (Fig. 2) occurring primarily during the day (Fig. 3, Table).