Panic Disorder and Heart Disease, PD&HD. A healthy heart makes for a better life. Our old ancestors believed that the heart is the master of the blood and the heart is the master of the mind. The heart has two meanings: the mental Mind and the heart Heart, and I believe that life is better if both are sound. The next thing I will introduce is a common psychological problem: anxiety. Acute anxiety is also known as panic attack or panic disorder. It is common in our clinical work to see patients with organic heart disease with anxiety, or anxiety that is somatized by cardiac discomfort. Panic PD originates from an ancient Greek myth in which a sky god named Pan would scare people to death with a haunting scream in their sleep. This sudden terror and fright is called panic. To give you an example of a typical case I see, I call it 120 women. Why? Because she calls 120 every time she has an episode of cardiac distress and is sent to the emergency room. I believe such patients are very common in our clinical practice. Such a patient may be seen with many relevant tests, such as ECG, chest X-ray, ultrasound, or even CT or coronary angiography. Often no positive results are seen, but she said to me, “This is the most terrifying experience for me.” We can see that the US DSM-IV on PD quantifiers mainly involve cardiac symptoms as much as palpitations, shortness of breath, chest pain, etc., so the cardiologist is the first physician to see for PD. Seeing this chart we can see dizziness. Sweating, chest discomfort, etc., but this is precisely a chart of chest pain typical of an acute heart attack. That is why PD is also known as the most prominent impostor. Further elaborated by epidemiological studies, it is mainly characterized by cardiovascular symptomatic discomfort manifestations, acute symptomatic visits, and repeated visits to the doctor. So some people statistically account for half of anxiety and depression in cardiology, one third of which is panic. So from the current biopsychosocial medicine model, those of us in cardiology who are the first consultation are more trusted by patients than those psycho-psychological professionals if we have relevant psychological knowledge. Therefore, it is necessary to understand more about panic. The etiological aspect involves biological and socio-environmental factors, which help us to develop psychological treatment. The mechanism of occurrence involves localization and characterization, which helps us to choose medications. Psychology has a very important cognitive model. Why did that 120 woman become ill? It stems from a life event as a trigger point. Her long-time snoring husband did not snore that night and she felt he was dying, involving separation anxiety, stemming from the childhood experience of separation from her parents. This alertness triggered somatosensory conditioning triggering cardiac discomfort emerged as a catastrophic cognition. Thomas talked about “nothing like fear of fear” every time she was alerted to a symptom, and there were four main aspects of PD: physiological, mainly sympathetic storms, somewhat similar to electrical storms; emotional, mainly anxiety, followed by depression; cognitive, believing she was dying of a heart attack; and behavioral. Repeated recourse to cardiology. There are three main diagnostic systems: CCMD3, DSM-IV, and ICD10. Treatment often includes medication and psychotherapy. Medications are often antidepressants (SSRI and tricyclics) and benzodiazepines BZD. tricyclics, which increase sudden cardiac death, are not chosen because underlying cardiac disorders cannot be ruled out, and SSRIs are commonly used. medication experience is SSRI combined with BZD, starting with small amounts, gradually increasing, maintaining treatment, and gradually decreasing. About psychotherapy, the old ancestors began to discuss it long ago. For example, in the “Ling Shu”, “the word is with its goodness, the guidance is with what it makes, and the opening is with its suffering”. It means to enlighten, suggest, change unreasonable cognition, adjust emotion, and adjust its spirit to facilitate its action. There are two main aspects of psychotherapy, the most important being the establishment of a good relationship, also known as a working alliance. Active attention, respect and warmth as well as sincerity are important. The second is the choice of an appropriate treatment model. The most effective is currently cognitive behavioral therapy. It alleviates symptoms by changing the patient’s misperceptions and reshaping behavior. The following modalities are available (omitted). For respiratory training modalities help to control acute exacerbation discomfort. The above is a cursory introduction to PD, which is actually integrated and integrated with the HD relationship. As a special concern for cardiac cases regarding risk factors, one of the nine risk factors for ESC is often overlooked: excessive stress. Stress can also trigger heart disease. Type A personalities in particular are particularly triggered by adverse psychosocial stimuli. A relevant differential diagnosis is thus made to differentiate between the two. However, I believe that the two should not be completely separated, otherwise the diagnosis will be missed and become misdiagnosed from one extreme to the other. For example, cardiac arrhythmias are often overlooked. This is why a cardiac and psychological interdiscipline was born —– bicardial medicine. To give two examples: ACS and Tako-Tsubo. diseases are interconvertible. Our wise ancestors made this clear long ago: abnormal emotions can induce or aggravate cardiovascular disease. “Sorrow and sadness move the heart.” Finally, I would like to share with you a quote that I hope will help you in your future work: as a first visit general hospital physician, although not like a specialist who does systematic psychotherapy, from clinical practice, every contact between the physician and the patient has extensive psychotherapeutic implications. At the time when the patient is most in need of help to save his or her life, a physician’s personality, education, experience and theory are organically combined to show understanding and give reasonable explanations for the patient’s illness, and in creative psychotherapy based on the patient’s comprehension, life events, age, personality, etc., to motivate the patient to explore the psychological mechanisms of his or her psychological disorder, which is the best and fastest treatment for the patient. It also improves compliance with medication, which is also the basis for curing the disease and preventing its recurrence. General hospital physicians will also experience a greater sense of accomplishment from effective treatment, which will lead to a virtuous cycle of greater willingness to focus on the psycho-spiritual health of their patients. I believe that the relationship between the heart and the psyche, and the relationship between the physician and the patient, is heartfelt. A healthy heart stems from a healthy mind, and that makes life better. Thank you!