Mr. Liu is a sales manager of a foreign company in Beijing, 40 years old. 2011 July by plane to Shanghai for a meeting, he suddenly felt a chest tightness, panic, sweating, hands and feet shaking during the flight, he thought he was suffering from a heart attack, at this time, he was dying on the plane, his heart was very nervous, had to call out for help, after the flight attendants comfort and give quick-acting heart pills to take. About 10 minutes later, Mr. Liu felt gradually relieved. But these ten minutes or so, he felt as if he had experienced a life-and-death catastrophe. After he got off the plane, he went straight to the emergency department of Ruijin Hospital in Shanghai. After a careful physical examination, ECG, chest X-ray and cardiac ultrasound, the doctor found no physical problems, his heart was functioning well, and all the physical examination indicators were normal, so he was reassured to go to work. He also did not put too much thought into this attack. But he was afraid to fly again since then, fearing that he would have another attack and would not be able to give help in time. Two months ago, he went to Shanghai again on a business trip and took the train instead, but the symptoms that appeared on the plane last time during the trip suddenly struck him again, and this time he believed that he must have had a heart attack, but after thinking about it, the symptoms were even worse than last time, and he felt that he was about to say goodbye to the world. Just sitting down in the car, he found that he was not uncomfortable. He was still unsure and went straight to the emergency department of this hospital, where the doctor gave him the necessary emergency medical examinations, but found nothing wrong with his body, so he was advised to go back to Beijing for a full examination, and if he could rule out “hidden coronary heart disease”, then it might be a psychiatric disease. After experiencing these two so-called “heart attacks”, Mr. Liu wondered how he could not find out what was wrong with him when he obviously felt so uncomfortable. Each attack is only a few minutes, especially like a heart attack, their symptoms are the same as those of their father’s heart attack when he was alive, how can we not find the problem? Could it be that he really has a mental problem? After returning to Beijing, Mr. Liu quickly went to Anzhen Hospital and underwent a comprehensive examination. All physical and laboratory tests revealed problems, and all biochemical indicators were normal. After so many days in the hospital, the doctor clearly told him when he was discharged that there was no hidden coronary heart disease as he suspected, and that he was in good health and told him to work with confidence. He was advised that he should see a psychiatrist, but he was very reluctant to go to a psychiatric hospital, believing that there was nothing abnormal about his mental health. One month ago, Mr. Liu was unhappy with his family at home because of a trivial matter, and suddenly he became irritable, restless, shortness of breath, chest tightness, palpitations, sweating, shaking hands and feet, pounding his chest, being at his wits’ end, feeling that he would go crazy, and having a sense of near death. Because he felt too uncomfortable and was worried about having another attack, he was in fear and anxiety all day long, and even thought of suicide, feeling so uncomfortable that it was worse than death. After a psychiatric examination and psychological examination, the doctor found that his main symptoms were anxiety and physical discomfort, and finally gave him the diagnosis of “panic attack”. He started taking antidepressants and anti-anxiety medication, combined with psychotherapy. In the psychotherapy, Mr. Liu revealed that his father died suddenly six months ago because of a heart attack. Since he felt that his life seemed to have no goal, the whole person seemed to have lost motivation, and he was afraid that he would die suddenly of heart disease in the future, just like his father. His parents were too busy to take care of him personally, so he was entrusted to his neighbor’s family from the age of 1 to 4. The neighbor’s family had three children, all older than him, and from the time he remembered 3, he was reluctant to go to the neighbor’s house, believing that the neighbor’s aunt treated him differently from his other siblings. After graduating from college, he started to work in marketing, and traveled all the time. After work, he always felt like a floating boat, very lonely. When I went to Shanghai for business, I felt that the customers were not very friendly and I was under pressure to meet them face to face. After 2 weeks, Mr. Liu’s symptoms basically did not reappear and he felt significantly better emotionally. Expert analysis: Conducting a psychological analysis, it is easy to see that Mr. Liu had the experience of separation from his parents in his early years, and was dissatisfied with that neighbor’s acting mother, and also developed a timid mentality, and the formation of a secure sense of attachment was hindered, so deep inside he grew up he was afraid of being away from home and of meeting any unfriendly people. The frail body as a child also nurtured the patient’s excessive concern for physical health. His father was the pillar of his heart, and his father’s sudden and long death deprived him of his psychological dependence, and also triggered his fear of death. These may be the reasons that trigger the patient’s inability to dispose of his inner conflict. Therefore, repairing the trauma of the patient’s early years and developing a secure attachment experience to reduce separation anxiety are the focus of treatment. From a psychiatric perspective, the symptoms of acute attacks of anxiety in such patients usually come and go suddenly. The patient’s fear attack has the following characteristics: 1. The symptoms are paroxysmal, not persistent, the attack is sudden, reaches its peak quickly, the consciousness is clear during the attack and can be recalled afterwards; 2. The attack of fear is not caused by objective things, situations, or situations, that is, there is no obvious trigger for the attack: there is no relevant specific situation and the attack is unpredictable; 3. There is no specific content of fear and fear, there is nothing to point to; 4. In the interictal period, there are no obvious symptoms except the fear of having another attack; 5. The attack is accompanied by obvious autonomic symptoms: palpitations, dyspnea, chest pressure, suffocating sensation, dizziness and swelling, and a sense of helplessness. 6. The seizures are accompanied by special experiences such as a sense of near death, a sense of losing one’s mind and having difficulty in controlling oneself, a sense of madness, and a sense of impending doom. In the early stages of the disease course, patients are often seen in the emergency department of general hospitals, where repeated extensive medical examinations do not reveal evidence of brain somatic lesions; 10. It is possible to exclude panic attacks secondary to somatic diseases such as epilepsy, heart attack, pheochromocytoma, hyperthyroidism or spontaneous hypoglycemia. Understanding the characteristics of panic attacks is also a reference method for patients to self-test for panic attacks. Experts suggest: 1, patients with such symptoms and their families, do not arbitrarily think that as long as there are panic attack symptoms must be a psychological disorder, but should first go to a general hospital to do a reasonable medical examination to exclude brain and body disease, only after the exclusion of brain and body disease, then consider the psychiatric diagnosis. 2, should believe in medical examination results, do not because the doctor did not find lesions, suspect that their “disease” is too complex, the existing medical means to find the cause of the disease, everywhere to seek medical advice, wasting a lot of medical resources. Instead, you should go to a psychiatric hospital in time. 3, because a considerable number of people think that a panic attack is a heart attack, so all year round equipped with quick-acting heart pills and other heart drugs, once a panic attack can not wait to take heart drugs, in fact, this is self-comfort. The reason is that panic attacks will naturally resolve in a short period of time even without any medication. Therefore, it is important to avoid “being heart attacked” and taking drugs by mistake for years. If the heart examination is free of disease, you should receive antidepressant and anti-anxiety medication, rather than taking drugs indiscriminately. If you can look at psychiatric treatment from a realistic point of view, it is not difficult to find that this worry is unnecessary, and you should follow medical advice to shorten the course of the disease and reduce pain. 5, the conditions should be combined with psychotherapy on the basis of medication. Systematic psychotherapy has a significant effect on the prevention of relapse.