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

### input:
hi i am a 20 year old female , recently i have been having reay bad anxiety! i was in the gym and use a watch to measure heart rate suddently my heart rate went up really high i was paying attention to the watch though! it happened twice in one week i felt a little light headed but did not faint! ive been to see cardiologist he done the stress test, ecg and a scan and sed i was perfect! i then went to see another doctor to get 2 more ECG done and they were fine too. i just cant believe the doctors and i am so anxious that i have palpitations all day long! even if i dont feel nervous my subconciois is causing palpitations and im scared. i dont want to start taking meds as im so young and this might just be a period of anxiety.

### output:

Greetings. Welcome to Chat Doctor, 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 Chat Doctor. 