PTH and chronic obstructive pulmonary disease: However, the authors interpreted these symptoms as physical equivalents of the psychiatric aspects of HypoPT disease on the grounds of high scores for anxiety, including phobic anxiety.(12) Recent data on cardiac contractility and the direct effects of PTH on cardiomyocytes may suggest that cardiac arrhythmias precede the anxiety perceived and therefore need to be regarded as causal and not consequential to anxiety in patients with HypoPT.