Clinical Cases

The Case of the Caged Heart – A Case of Vasospastic Angina

Homeopath Anke Zimmermann presents a case of vasospastic angina in a woman of 48.

I first saw Michelle, a 48-year old female, on November 14, 2008. Her chief complaint was angina due to vasospasms for the past two years. The symptom picture was one of classic angina, but there was no blockage of the arteries. The patient was rather annoyed by the angina.

“I have no time for this. I resent having to pay attention to my body. I’ve got things to do. I’m still mad at the doctors who diagnosed it.”

How did her heart feel about this?

“I think my heart wants a break. It wants a rest between beats. I was taking on all the responsibility of the world, doing far too much.” She was feeling out of breath telling her story.  “But I feel I’m not big enough for the job. I feel I don’t have the skills. What I really want to do is to be silly and play!”  “The amazing thing is that I do so much. I do the teaching, bookkeeping, the bodywork, I push myself to do more and more. I feel I have to earn my keep to feel secure.”


“I’ve never felt secure. I’m always looking at the conflict around me. I grew up with four older sisters. All five of us girls were born in five years. My earliest memories are of all the arguing between themselves. I felt responsible for it. There was conflict and it was my job to fix it.”

And if she did not do that?

“They’d tear each other apart!”

She would hide a lot as a child to get away from the conflict. She has had concerns about security and money for most of her life. At the same time she has always had a strong desire for escape and freedom.

“I had horses all of my life, since age 4. It was the whole freedom thing, galloping off with a horse. It was my escape and expression.”

Analysis and Plan:

A 48-year old woman with vasospastic angina for two years. She came in as an acute so I did not have enough time to take a proper case and kind of shot from the hip a bit with the prescription. Based on her high conflict family of origin and desire to escape I decided to give her Stramonium 200CH. This actually improved her condition by about 50% over the next few months but then the progress stalled.

Follow-up June 3, 2009

I finally saw her for a detailed case-taking seven months after the initial appointment, where she gave me the keys to her case very beautifully.

“The feeling of the heart being squeezed is very much like a block, a barrier. I’m always pushing it. It feels like a cage. Right when I want to expand, take a deep breath – it fastens around me. It says “No getting big for you! Don’t get too big for your boots and no, you can’t go and have fun.”

What is it like to be big?

“To be free-flowing, easier. I can lift more with the same effort. Breathing is easy. I’m happy and cheerful and content. I’m worry-free and things smell good.”  “I grew up on a farm but had allergies, so I would not dare to take a deep breath. It would compress me and make me feel smaller. I like to breathe big, rich, feel fulfilled, happy. The restriction comes from outside, making me smaller, keeping me where I’m supposed to be.”

Tell me more about restriction?

“I have a picture of a cage around the ribs in my mind. There is a big cage around my chest and a smaller one around my heart. It is like expanded metal, dull grey in colour.”  “It seems pretty rigid and solid and permanent. It is cold. It does not care. It is there to keep the body safe and me in line.”

What would happen if it did not do that?

“I’d be unrestrained. I would be ridiculous, silly, extravagant and irresponsible. Everything would fall apart, all order would cease, I’d be late for school and the clothes would not be washed.”

By now I was thinking that she might require a remedy made from a bird. So I asked her how she felt about birds.

“I would never own one. The idea of the cage is horrible. I love watching and feeding them. They have a really neat perspective on things, quite elevated and special. Birds can see things from all angles, on the ground, from the air, from trees, close up and far away. They are flexible and motile.” “They have a very simple existence, very life and death, but very straightforward.” “And virtually no responsibility.” “They build their wing and heart muscles as a side effect of having a great time!”

It was amazing. Those were her exact words, “they build their wing and heart muscles as a side effect of having a great time”, exactly what she wanted to do, but could not as a result of feeling the excessive and impossible responsibility of resolving all conflict.

She described her heart as being in a cage and was longing for freedom, just like a caged bird. She also experienced her whole being as small and confined when she wanted to be big and play. In birds she could see the ability to see from all angles, which, interestingly, is important in conflict resolution.

I decided to give a homeopathic remedy made from the bald eagle, Haliaetus leukocephalus, 200 CH. I did not repertorize this case, to be honest, but decided on the prescription based on my knowledge of bird remedies, especially from studying Jonathan Shore’s book [1].

Email feedback June 14, 2009:

“After I saw you I had the most incredible flying dream. I was with someone and we were very high up in the sky. He was showing me around and I was really surprised at how smooth and beautiful and frictionless everything was at this height. The patterns of the fields and rivers and forests were breathtakingly perfect.”

“I also commented on there being no wind while we were flying, it was so easy and comfortable and effortless… He said “that’s the way it always is – it is set up that way.”

“On Saturday we went for a hike up that hill we often climb and we know exactly where we have to rest on the steep parts for my angina. I did not have to stop. I had a small amount of tightness, but not enough to make me stop. Last time we went I had to stop for ten minutes half way up!”

“We’ve been for a couple of walks since and I’d say there is a definite improvement. So the eagle remedy is clearly a winner.”

This patient did very well on Haliaetus, her angina improved by 90% and her whole outlook changed. She no longer felt as if she was responsible for everything and started to have a lot more fun and freedom in her life. She even went back to school and changed her career.

In April of 2010 she came to see me complaining about some joint problems in her fingers which had not improved with Haliaetus.  I then gave her Syphilinum 1MK, as a result of reading Jeremy Sherr’s book on Syphilis [2]. He feels that Haliaetus is a syphilitic remedy and since it helped her so much but did not improve her joints I decided to give the nosode. It improved her joints marvelously.


[1] Birds, Homeopathic Remedies from the Avian Realm. Jonathan Shore, MD, Judy Schriebman and Anneke Hogeland, 2004, Homeopathy West

[2] Dynamic Materia Medica – Syphilis. Jeremy Sherr, 2002, Dynamis Books

About the author

Anke Zimmermann

Dr. Anke Zimmermann, BSc, ND, FCAH, is a naturopathic doctor specializing in homeopathy. She also has a special interest in childhood developmental disorders and CEASE Therapy. Dr. Zimmermann has been in clinical practice for 23 years and works and lives in beautiful Victoria, BC, Canada. Visit Dr. Zimmerman at her website:

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