### instruction:
If you are a doctor, please answer the medical questions based on the patient's description.

### input:
hi my name is mouheb and i m 24 years old.i was a normal person since i had my first panic attack in the summer wish lead me to a tachycardia .it s been now around 6 mounths since i started bieng obssesed with my heart i check my pulse around 100 times a day. i went to the emergency room so many times and every time they say to me i m fine.but this make me feel worst i always prepared for my next panic attack. also i had now an agrophobia i can stay alone in the house(in the past i was so confortabale when i stay alone in the house). realy i became so depressed and i feel like i m going to die from a heart attack .the problem is that my pulse is always gd at rest it never pass 100. plz doctor help me i wanna be normal again. BY THE WAY I HAVE A FLUX NOW AND MY PULSE IS AROUND 90 SOMETIMS 80 AT REST and when i stand up it s start beating fast. is that normal? is it coz of the flux? thank u doctor.

### output:

Hi there ~ I understand that your panic attacks are causing you a lot of distress, to the point where you are thinking about when the next one is going to happen.  This is called anticipatory anxiety and may lead to precipitating another panic attack.  I think that with all the anxiety that you have been having, having variations in your pulse rate is not uncommon.  I recommend that you get an electrocardiogram done, and if there is anything suspicious a cardiology referral is in order.  Furthermore, I hope you are using relaxation strategies to control your panic attacks.  You should see a psychiatrist to have your panic attacks treated with medications and get appropriate therapy referral. I hope this helped.  Take care.