Greetings. Thank you for your question and welcome to HCM. I understand your concern. The flush of adrenalin and noradrenalin in the system, characteristic of panic attacks and generalized anxiety disorder, is accompanied with rapid heart rate, high blood pressure, shortness of breath, sometimes dizziness and other symptoms, such as chest pain. Panic attacks do not have a known cause, there are only theories regarding this issues. However, they have known triggers and, I assume, you know them best. It is a public speech or performance, going in crowded places, or going into an elevator, that trigger the panic attack and the common question in one s head how am I going to get out if something terrible happens? I am going to faint in front of all these people? Am I going to die? Is something terrible happening to me? etc. All the symptoms from this point on are attributed to the mechanism described above. But, if these are very worrisome events to you and they affect somehow your quality of life, school or sleep, I encourage you to see a psychiatrist and discuss about a course of sedatives to treat this situation. Also, I recommend you to get an EKG just to exclude any cardiac origin to this problem. I hope I was helpful with my answer. Regards, Dr. Meriton