Greetings. Welcome to HCM and thank you for your question. I understand your concern. If it was something heart-related, at your age there are rare conditions that can be inherited disorders, that would have palpitations for symptoms. However, these disorders are almost always caught in the EKG, and each one of them has specific EKG signs. Therefore, we ruled that out. You mentioned that the jump starting of the heart happened in the gym. It is normal for the heart rate to go up while being physically active. In your case, it is tolerated up to 200 beats per minute (220 - age, is the formula). The anxiety or panic attacks are almost always triggered by some event, such that, the person experiencing them, knows which places or venues will trigger their attack, such as public speaking or performance, crowded places, narrow pathways etc. It works in that way that a certain phenomenon causes the panic attack. From that moment on, every single symptom you experience, comes from anxiety: shortness of breath, high heart rate, high blood pressure, sometimes dizziness or blurred vision. If this situation is affecting your quality of life, then I would recommend you to be started on a course of combination of a drug from the benzodiazepines and a drug of antipsychotic medication. They will help you suppress and prevent the anxiety attacks. I also recommend you to consult a psychiatrist, about the dosage and frequency of these drugs. In the end, I would recommend you to keep being physically active, as physical activity has great benefits in the state of the mind. I hope I was helpful. Kind regards. Dr. Meriton