Question: Helllo, for the last two months ive been having panic attacks when i try to exersise or masterbate. what happens is my heart beats really fast i get shaky in my head and ribs and feel impending doom.and feel like im going to pass out, but i never do. the episodes tipcally stop when i stop exersising and i recover quickly tipcally the beating goes down in a few mins, panic lasts from 5-60 mins. ive had an echocardiogram,chest ct and xray, brain mri, thyroid and cealic blood tests sleep apnea test all came back good. i did lose my father and grandfather 9 months ago and my doctor believes i have ptsd. i am of healthy weight. walk everywhere i go. but as a child was a second hand smoker for 18 years and used norco on and off for four years, been clean for three years. i use to be obese as a kid 237 pounds at 14 now at 21 im 174 pounds 6 ft. i dont have high blood pressure. no obvious signs of diabeates. resting pulse is usually between 58-74. my standing or walking pluse is usually between 88-106. i have a history of social anxiety and medical anxiety, but these new symptoms came out of nowhere. can ptsd really cause these psychial symptoms that i feel? should i worry about atrhmiyas or coranary artery disease. also when i lay in bed my stomach makes a lot of noises, i get gasy and it almost sounds/feels like fluid.

I am starting cognitive behavior threaphy. Should I worry about heart disease? Most of the symptoms I get with exertion I will get at rest or social situations. Also can cbt work without meds?

Also the digestive symptoms are constant weakness in lower ribs and pain in upper abdomen but worse when laying down or in stress events. Also if I may ask have you ever had any other patients who had the symptoms I had during exerscise and masturbation?

Thank you doc, I most certainly will. My final two questions for you are:
1. Can panic ptsd or anxiety cause panic attacks right at the beginning of a workout that feel like shaking and impending doom with fast pulse and feeling faint. Also for the masterbation I won't get an erection, I will just start to tough my self a little and than I will get shakey in my ribs head and penis this came out of nowhere, same with exerscise. Ironically enough I still get morning erections.

2. I have pain in my ribs and upper gut almost always. Are these signs of anxiety as well?

3. Is there a possiabley of this being cardic in nature with a panic disorder? Should I push for a stress test?

Thank you for your time doc. i guess ive just been scared because one month i was moshing at concerts and the next month the slightest bit of exercise would send me into a panic attack. i also get panicky and shakey when feeling any sort of emotion. where my heart would beat fast and i feel like im dieing and i shake all over. this started out of no where. although i will admit. i was always waking up very tired and low of energy before my panic attacks started. i mean 6-7 months before hand. now i get the panic attacks but the day time sleepiness dose not occur as much, just low energy level ir just feels so much like a heart issue, but i get milder attacks of the same nature at rest and in social situations. ive been experiencing acid reflux for almost two years now. ever since getting of norco. (pain killer) is there anything else possibly going on here?