Symptoms of chest tightness shortness of breath dyspnea and panic attacks may be related to impaired heart function, lung function, or may be cardiac neurosis. There are many causes of chest tightness shortness of breath dyspnea panic, firstly, heart disease needs to be ruled out. Secondly, it is also necessary to exclude the possibility of lung diseases caused by chronic bronchitis, chronic obstructive pulmonary emphysema, lung infection, pneumothorax, lung cancer, etc. 1, heart causes: more common is coronary heart disease. If there is a previous history of coronary heart disease, the sudden appearance of unexplained chest tightness shortness of breath dyspnea panic, may be related to the occurrence of acute myocardial infarction. Another relatively common cause is viral myocarditis, which damages myocardial structure and function due to the direct action of a virus or the combined action of a virus and the immune response of the muscle. Pericarditis can also cause these symptoms. Heart failure is also a cause of chest tightness and breathlessness. When the decline in cardiac function is severe, manifestations such as exertional dyspnea and telangiectatic breathing may occur. Cardiac enzymes, troponin, electrocardiogram, echocardiogram, chest X-ray, coronary CT, cardiac MRI or coronary angiogram can be used to clearly exclude heart disease problems. 2, pulmonary causes: more common chronic bronchitis, chronic obstructive pulmonary emphysema, lung infection, spontaneous pneumothorax, lung cancer, etc. Chronic bronchitis and chronic obstructive pulmonary emphysema can easily cause chest tightness and shortness of breath during acute infection. Pulmonary infections such as lobar pneumonia can lead to solid lung changes, resulting in dyspnea; in spontaneous pneumothorax, the lung will be squeezed and shrunk due to the loss of negative chest pressure; lung tumors cause partial airway obstruction to produce symptoms of chest tightness and shortness of breath. When the tissue is deprived of oxygen during dyspnea, the oxygen supply may be promoted by accelerating the heart rate, thus producing the feeling of panic. It can be clarified by chest X-ray, lung CT, bronchoscopy, etc. 3.Cardiac neurosis: If the organic lesion is not found even after cardiopulmonary function examination, then cardiac neurosis should be considered. Cardiac neurosis is mostly seen in women aged 20 to 40 years old, especially menopausal women. There is no pathological evidence of organic heart disease. Symptoms are varied and may include chest tightness, breathlessness, often feeling that there is not enough air to open the window or requesting oxygen, and many patients often do deep breathing or sigh-like breathing movements to relieve symptoms, leading to hyperventilation, causing respiratory alkalosis and worsening symptoms. They may also feel palpitations and feel an increased heartbeat, often aggravated by stress or fatigue. Further consultation at the psychosomatic medicine clinic is possible. Chest tightness and shortness of breath dyspnea and panic may be related to impaired cardiopulmonary function and require immediate medical attention to rule out the possibility of a life-threatening cause.