Inclusion Criteria:  Adult emergency department (ED) patients (≥18yoa) presenting to the ED Within 1 week of ED presentation if discharged at time of screening. Chief complaint of chest pain or similar chief complaint leading to a standard of care diagnostic protocol to rule out possible acute coronary syndrome. HEART Score of 0-3 indicating Major Adverse Cardiac Events (MACE) risk equivalent to ≤2% "Functionally" low risk status - (moderate HEART score of 4-6) plus diagnostic protocol evaluation with at least two serial normal troponins spaced at least six hours apart with or without cardiovascular stress testing in the observation unit. Moderate to severe anxiety as defined by a GAD-7 score ≥ 8 or a PHQ panic screener score ≥ 2 Expected to be discharged from the ED or only undergo observation <24 hours.  Exclusion Criteria:  > 1 week from ED discharge Traumatic reason for chest pain Those admitted to the hospital (inpatient status) as part of their ED presentation (those placed in the observation unit for planned observation less than <24 hours are eligible) Active psychosis or behavioral issues requiring psychiatric monitoring or consultation of psychiatry for psychosis, schizophrenia, or suicidal ideation Hemodynamic instability as assessed by the treating provider Issues likely to affect follow up, including prisoners and homelessness Inability to understand and speak English to participate in telehealth therapy sessions and peer support.