Coronary Heart Disease (or Ischemic Heart Disease)
1. PRELIMINARY DATA
- No.: 201/2026
- Patient's Name: ABC
- Address: 123, Karve Road, Pune
- Occupation: Software Engineer [chronic stress due to long working hours and deadlines]
- Religion: Hindu
- Date: 01/03/2026
- Age: 45 Years
- Sex: Male
- Education: Bachelor of Engineering
- Status: Married
2. CHIEF COMPLAINTS AND ASSOCIATED TROUBLES
| LOCATION | SENSATION & PATHOLOGY | A/F & MODALITIES | CONCOMITANTS |
|---|
| Chest | Dull ache, heaviness, occasional sharp pains | <at rest, >by movement, since 6 months | Anxiety, restlessness |
| Left arm | Numbness, tingling | <by exertion, >by rest | Shortness of breath |
3. PERSONAL PAST & FAMILY HISTORY
- Past History: Hypertension for 10 years, treated with conventional medicines.
- Family History: Father had myocardial infarction at the age of 50, mother has diabetes.
- Developmental Landmarks: All milestones were reached at the appropriate age.
4. PATIENT AS A PERSON (PHYSICAL CHARACTERISTICS)
A. Physical Characteristics
- Appetite: Good
- Desires: +++ Spicy food, +++ Non-vegetarian food
- Aversions: None
- Thirst: Normal
- Elimination:
- Urine: Normal
- Stool: Constipated
- Perspiration: Profuse, especially on palms and soles
- Sleep: Disturbed, due to anxiety and restlessness
- Thermal State: Hot, prefers cooler environments
B. Reactions - Physical Factors
- Weather: <Summer, >winter
- Position: <Lying on the left side, >sitting up
5. MENTAL STATE (Psychodynamic & Life-Space)
- Nature: Ambitious, perfectionist
- Anxiety: Fear of failure, fear of death
- Fear: Fear of losing loved ones
- Dreams: Recurrent dreams of being chased
- Other: Irritability, mood swings
6. PHYSICAL GENERAL EXAMINATION
- Wt: 75 kg | Ht: 170 cm | Temp: 98°F
- RR: 24/min | Pulse: 96 bpm | B.P.: 140/90 mmHg
- Face: Pale, anxious expression
- Tongue: Dry, coated
- Nails: Brittle
- Skin: Dry, rough
7. SYSTEMIC EXAMINATION
- CVS: S1, S2 normal, no murmurs
- Respiratory: Bilateral lung fields clear
- GIT: Tenderness in the epigastric region
8. ANALYSIS AND EVALUATION OF SYMPTOMS
- Mental General: Anxiety (Grade 3)
- Physical General: Heaviness, pain in the chest (Grade 3)
- Particular: Numbness in the left arm (Grade 2)
9. SELECTION OF REPERTORY WITH REASON
- Repertory: Kent’s Repertory of Homoeopathic Materia Medica
- Reason: Chronic case with strong Mental Generals and Physical Generals dominating over particulars; Kent's hierarchy suits constitutional approach.
10. TOTALITY OF SYMPTOMS FOR REPERTORISATION
- Anxiety and fear of death
- Heaviness and pain in the chest
- Numbness in the left arm
- Irritability and mood swings
- Desire for spicy and non-vegetarian food
- Aversion to none
- Profuse perspiration, especially on palms and soles
- Disturbed sleep due to anxiety and restlessness
- Hot thermal state
11. CONVERSION INTO REPERTORIAL RUBRICS
| SR. NO. | SYMPTOMS | RUBRICS WITH SUB-RUBRICS | PAGE NO. (Kent) |
|---|
| 1 | Anxiety, fear of death | Fear; death, of | 203 |
| 2 | Heaviness, pain in chest | Chest; pain, heaviness | 678 |
| 3 | Numbness in left arm | Arm; numbness, left | 345 |
| 4 | Irritability, mood swings | Mind; irritability | 102 |
| 5 | Desire for spicy food | Food; desires, spicy | 456 |
| 6 | Profuse perspiration | Perspiration; profuse | 789 |
| 7 | Disturbed sleep | Sleep; disturbed | 234 |
| 8 | Hot thermal state | Temperature; hot | 567 |
12. SELECTION OF REPERTORIZATION (NUMERICAL ORDER)
| SR. NO. | REMEDIES | RUBRICS COVERED | TOTAL MARKS |
|---|
| 1 | Arsenicum | 5, 6, 7, 8 | 20 |
| 2 | Lachesis | 1, 3, 4 | 15 |
| 3 | Nux Vomica | 2, 5 | 12 |
13. MIASMATIC INTERPRETATION
| PSORA | SYCOSIS | TUBERCULAR | SYPHILIS |
|---|
| Anxiety, fear | Irritability, mood swings | Heaviness, pain in chest | None |
Dominant Miasm: Psora-Sycotic
14. FINAL STEPS
- Provisional Diagnosis: Chronic Coronary Heart Disease
- Differentiation of Remedies: Arsenicum and Lachesis both cover important symptoms, but Arsenicum matches the patient's anxiety, fear, and thermal state more closely.
- Selection of Remedy (Materia Medica): Arsenicum matches the deep constitutional picture, including anxiety, fear, and physical symptoms like chest pain and numbness in the arm (Ref: Allen’s Keynotes, Boericke).
- Selection of Potency: 200C (Chronic deep-seated case, sensitive constitution)
- Actual Prescription:
- Arsenicum 200C — single dose
- Placebo — 4 pills twice a day for 2 weeks
15. FOLLOW-UP'S TABLE
| DATE | COMPLAINTS | REMEDY | ADVICE |
|---|
| 15/04/2026 | Partial improvement in anxiety, some reduction in chest pain | Placebo | Continue lifestyle modifications, follow-up in 2 months |
| 15/06/2026 | Further improvement in chest symptoms, numbness in arm reduced | Arsenicum 200C (repeat) | Continue medication, monitor blood pressure and lipid profile |