Biliary heart syndrome is a disease of cardiac discomfort and ECG abnormalities caused by biliary tract diseases (acute and chronic cholecystitis, gallstones, etc.). The severity of cardiac discomfort is positively correlated with the condition of biliary tract diseases; there is no organic lesion of the heart, and cardiac symptoms are relieved or even completely recovered with the control or cure of biliary tract diseases. Coronary artery disease is a group of clinical syndromes in which structural and/or functional abnormalities of the coronary arteries cause coronary stenosis, spasm and/or occlusion, resulting in myocardial ischemia and/or infarction. Pain in the retrosternal or precordial region is palm-sized, paroxysmal and of short duration (1-15 min each time), with a feeling of pressure and frequent death, which can be induced by exertion. The pain may radiate to the left neck and left upper extremity and may be relieved by rest or sublingual nitroglycerin. How to distinguish biliary heart syndrome from coronary artery disease clinically? In clinical practice, cardiac symptoms and electrocardiogram changes in gallbladder and biliary tract diseases without a history of heart disease, or those who have coronary heart disease symptoms and the long-term application of anti-coronary heart disease medication is not effective, should consider the possibility of biliary heart syndrome, especially when the symptoms of coronary heart disease and biliary tract symptoms are accompanied by biliary heart syndrome. However, biliary heart syndrome is not easily diagnosed before cholecystectomy, and in most cases the diagnosis is only confirmed after surgery or the disappearance of cardiac symptoms after aggressive and effective biliary medical treatment. The biliary heart syndrome often attacks after a full meal, especially after eating fatty foods, and it also attacks easily at night when lying down, and it is colic in nature, often lasting longer (several hours or even more than 10 hours), and nitroglycerin is ineffective, and the arrhythmia cannot be controlled with anti-arrhythmic drugs, while atropine, dulcolax and other drugs to reduce biliary colic can correct the arrhythmia. The angina pectoris and ECG abnormalities in biliary heart syndrome are transient, consistent with the severity of biliary tract disease, and disappear with the cure of biliary tract disease. In addition to cardiac symptoms, most of the biliary heart syndrome has corresponding clinical manifestations of biliary disease itself, such as pain and pressure in the right upper abdomen, radiating pain in the right shoulder and scapular area, jaundice, fever, etc.