Heart Issues?

22M with recent high stress (graduation/job uncertainty) developed chest discomfort 3 days ago after overeating and anxiety episode. Symptoms include left chest tightness, intermittent left arm/neck sensations, and GI cramping. Symptoms worsen with attention and standing, improve at rest, and do not occur during exercise.

Seen in clinic: panic attack with tachycardia, normal EKG, normal heart exam. Given propranolol (not taking) and inhaler (childhood asthma history).

History: multiple normal echocardiograms, ED visit 10–11 months ago with normal workup including troponin 40 ng/L (within range), no cardiac diagnosis.

Able to perform high-intensity incline cardio without symptoms.

Concerned about heart disease vs anxiety/musculoskeletal causes. Asking if cardiology follow-up is needed and if exercise is safe.