instruction: hello doctor I am a 23 year old male two years ago I had intense palpitations and I was diagnosed with anxiety disorder I had panic attacks but then I was able to recover by myself from a few days I had two panic attacks and I am afraid if this is anxiety or if my diagnosis was wrong as if I had some serious health issues I worry that I have a heart problem even if someone touches my chest I feel uncomfortable I do not think a lot I try to calm myself but somehow I am not able to calm myself no matter what I try the main problem now is my anger I suddenly feel so much angry on very stupid things like I am walking on a road and a car blows horn continuously I feel very irritated and angry if my girlfriend does not pick my call I get so much angry and it is not normal if I try to control my anger I feel numbness and hand shakes I even have palpitations this is very worrying for me as I think this is very serious this time my heart palpitations go away only when I am in deep sleep or when I am doing something so deeply without noticing anything I had palpitations two days before my exams I tried calming technique but it did not went away but when I was in the examination center when I started writing my answers I was so deeply busy in writing that my palpitations go away and then after the exam I was fine but anger is ruining my life I want to change the way I am please help I am currently taking sertraline and beta blockers
output: hello panic attacks often mic a heart attack in fact one of the common differential diagnosis for panic attack is cardiac arrest if it is happening often it is advisable to get an egg electrocardiogram done please tell me from last how many days are you taking anti anxiety medications secondly I would advise you to start cognitive behavior therapy anxiety is caused by negative thoughts called cognitive distortions these can be improved with various techniques used in the therapy once you learn how to cope up with these negative thoughts you will be able to control your anxiety find a local therapist or you can opt for online therapy via video consultation the relaxation techniques such as box breathing and progressive muscle relaxation help in long term efficacy I hope this helps