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

### input:
I was getting fed up with all the panic attacks! they increased to 178 beats per min! these are not your normal anxiety attacks! this is where your ox.. level drops! get weal.. light headed like your going to pass out!... the e mt. gave me the medication.. through the veins to get the heart beasts back to normal! forgot the name of this! they are saying the c o p d.. allergies are putting strain on the heart muscle.. have thromboses that causes most of this! poor circulation! was put on medium doses of dilitazem.. is this medication related to what I was given in the e m t,s truck?

### output:

Hello! Welcome and thank you for asking on Chat Doctor! I carefully passed through your question and would explain that panic attacks can trigger all this clinical scenario. But a cardiac arrhythmia can not be excluded either. You should know that Diltiazem is a calcium channel blocker, which helps lower your heart rate and prevent possible cardiac arrhythmia. Anyway, considering all your symptoms, I would recommend consulting with your attending physician and performing some tests to investigate for the possible underlying causes: - a cardiac ultrasound to examine your heart- an ambulatory 24-48 hours ECG monitoring to examine your heart rhythm trends and exclude possible cardiac arrhythmia- a chest X-ray study and pulmonary function tests - complete blood count for anemia-thyroid hormone levels for thyroid dysfunction - blood electrolytes for possible electrolyte imbalance. You should discuss with your doctor on the above issues. If all the above tests result normal, you should consider anxiety as the main cause underlying your complaints. In such case you should discuss with a specialist of this field to help you manage anxiety. Hope to have been helpful! Wishing all the best, 