If symptoms such as panic, shortness of breath and chest tightness occur frequently in the middle of the night, first of all, we should exclude arrhythmia as well as coronary artery disease and angina pectoris. Patients with arrhythmia or coronary artery disease or angina often have clinical symptoms of chest tightness and chest pain after activity, or panic and shortness of breath. However, if it occurs at night, it is a small probability event because sympathetic excitation is often not obvious at night and vagal excitation plays a major role, when the patient’s heart rate is often slowed down and blood vessels are dilated, so that adverse cardiovascular events do not easily occur. If at this time and stage there are manifestations such as panic and shortness of breath, firstly we should consider unstable angina in coronary heart disease, especially variant angina and prone angina, and these episodes of angina may occur with panic to the point of waking up in the middle of the night. Secondly, sudden arrhythmias, which are manifested by repeated panic and palpitation sensations in patients, specifically including paroxysmal supraventricular tachycardia, as well as atrial fibrillation, atrial flutter, etc. Frequent ventricular prematureness can also result. Such patients should go to a nearby hospital for an electrocardiogram as soon as possible during the attack to determine what kind of arrhythmia is present and to facilitate symptomatic treatment by a cardiologist. Finally, although the patient does not have coronary artery disease or arrhythmia, the patient has cardiac insufficiency, which is often referred to as heart failure. Patients who have heart failure are prone to sudden illness during the course of the night. Because the diaphragm of the lungs will be elevated at night, blood will flow back into the heart or lungs from the lower extremities, which will aggravate pulmonary stasis. Therefore, patients who fall asleep in a flat position in the middle of the night with cardiac insufficiency often experience recurrent coughing and shortness of breath at night, even sitting up to get better, along with palpitations. Such patients undergo cardiac ultrasound to further clarify the diagnosis.