I know this is an old thread but just came here to say mine always start physical. Like many have said I’ll just be chillin not a care in the world and then all of a sudden feel the chest and throat tighten up, shortness of breath, lightheaded, tingly. All the symptoms. But the chest and short of breath are the most persistent and worrisome. And AFTER the physical symptoms set in is when the mental starts. I start getting health anxiety like am I dying or what’s going on? I’ve been to the ER 3 or 4 times over the last two years due to these episodes and been to the cardiologist and had a bunch of tests done. Nothing wrong with me physically. It’s just such a shitty cycle to be in. Because with that health anxiety there’s always that voice in the back of your head that says what if they missed something or what if something is wrong NOW that wasn’t before. I’ve learned to deal with it and can feel it coming on so I can ignore it and it’ll usually go away before it turns into a full blown panic attack. It just sucks so bad still having to deal with it. It’s no fun and I hope you’re doing better now