This article interprets the pathological characteristics of coronary heart disease in the elderly from the perspective of the dysregulation of the "Qi - Blood - Vessel - Spirit" chain. It posits that deficiency is the fundamental basis of coronary heart disease in the elderly, with qi deficiency being the initiating factor. Prolonged qi deficiency leads to stagnation of deficient qi, which affects the blood, making qi stagnation and blood stasis the primary cause. When deficient qi stagnates in the vessels, vessel obstruction becomes the key pathological mechanism. When deficient qi stagnates and affects the spirit, mental restlessness becomes an independent risk factor. Based on this, the article summarizes the experience of the renowned traditional Chinese medicine practitioner Guo Shikui in treating coronary heart disease in the elderly by focusing on restoring the "Qi - Blood - Vessel - Spirit" chain. Specifically, for deficiency, tonifying qi is essential, promoting free flow through tonification; for blood stasis, activating circulation is appropriate, using free flow as tonification; for vessel obstruction, promoting free flow is crucial, warming and unblocking to relieve pain; for mental disturbance, harmonizing is the norm, resolving stagnation and calming the spirit. The aim is to provide a perspective and method for the treatment of coronary heart disease in the elderly with traditional Chinese medicine.

Senile coronary heart disease  /  "Qi - Blood - Vessel - Spirit" chain imbalance  /  Renowned veteran TCM physician  /  Guo Shikui