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Heartache due to the Foot Jueyin (Liver) channel presents with tension in both hypochondria, with pain radiating to the lower abdomen and connecting to the inner thigh, causing mutual pulling pain. Heartache due to the Hand Jueyin (Pericardium) channel involves pain penetrating through to the back, accompanied by vexation, heat in the palms, dryness of the throat, yellowing and reddening of the eyes, and fullness in the hypochondria. Heartache due to the Foot Taiyin (Spleen) channel manifests as abdominal fullness, astringent difficulty in defecation, obstruction at the diaphragm, and a sensation of blockage in the throat. Heartache due to the Hand Taiyin (Lung) channel is characterized by shortness of breath insufficient for respiration, empty pain in the lateral costal margin, uncontrolled loss of urine and feces, chest fullness, and vexation. Heartache due to the Foot Shaoyin (Kidney) channel presents with severe vexation, black complexion, a sensation of hunger-like emptiness in the heart, chest fullness, and pain in the waist and spine. Heartache involving the Back-Shu points of various channels features mutual traction between the heart and the back, where heartache penetrates to the back and backache penetrates to the heart. Heartache arising from the Fu organs makes it difficult to bend or extend the body, with upward rushing of Qi in the lower abdomen, sudden loss of consciousness, vomiting, and diarrhea; these are all diseases caused by pathogenic factors affecting various channels, Shu points, and Fu organs, belonging to External Causes.

Liver heartache is characterized by a pale cyan complexion resembling dead ash, with an inability to sigh deeply throughout the day. True heartache presents with cyanosis of the hands and feet extending to the joints; if it occurs in the morning, death ensues in the evening, and if in the evening, death occurs in the morning. Spleen heartache feels like needle-like stabbing in the heart and abdomen, with a feeling of Qi stagnation and fullness. Lung heartache seems to originate from the heart region, worsening with movement, while the complexion remains unchanged. Kidney heartache involves mutual traction with the back, frequent spasms, a sensation as if an object is touching the heart from behind, and a stooped posture. Stomach heartache presents with abdominal fullness, inability to eat, and indigestion after eating. These are all caused by imbalance of Zang Qi due to emotional factors such as anger, joy, and depression, belonging to Internal Causes.

Long-standing accumulated heart and abdominal pain results from consuming cold raw foods and fruits, leading to Cold in the Middle Jiao that fails to dissipate, condensing into an accumulation. In severe cases, one cannot eat for several days, passes dry blood, and experiences irregular vomiting and diarrhea. This is caused by accumulated matter lodging between the stomach and intestines, re-triggered upon eating, known as Accumulation Heartache. When heartache is caused by intestinal roundworms due to visceral Cold, it presents with pain in the heart and abdomen, episodic swelling and gathering moving up and down, intermittent pain, abdominal heat, and salivation; this disease belongs to Neither-Internal-Nor-External Causes. The nine types of heartache mentioned in formulas and syndromes are: Drink, Food, Wind, Cold, Heat, Palpitation, Worm, Transmission, and Migratory Pain. Among these, Wind, Heat, and Cold belong to External Causes, while the rest belong to Neither-Internal-Nor-External Causes. Additionally, in women, evil blood entering the Heart and Spleen channels causes pain that is more severe than other pains. Sudden attacks by Guest Worry (Ke Wu), Ghost Strikes, or Corpse Transfusion pathogens also cause heartache, which similarly belongs to Neither-Internal-Nor-External Causes.