Hello dear, Thank you for your question. Given your history of obesity,smoking and alcohol consumption, in my opinion you need a consult with a cardiologist. These three are considered as main risk factors for heart disease despite your young age. The pain and irregular heartbeat may or not be just associated with your panic attacks, but nonetheless visiting your cardiologist may discover a disease that hasn t appeared with symptoms. Your symptoms may be considered as manifestations of panic attacks, only after every organic cause has been excluded. Visiting your cardiologist is very important since it may discover the reason behind chest pain and irregular heartbeat, and/or some other disease that has not manifested with symptoms yet. I would insist in some lifestyle modifications that will not only reduce your overall heart disease risk, but also improve your quality of life: 1- a diet rich in fruits and vegetables 2- avoid high fat and sugar content foods 3- engage in aerobic physical activity (ie 30 min of walking or cycling) 4- cessation of smoking and excessive alcohol consumption You are in your 30s, therefore if you follow your lifestyle changes that is excellent chance to improve your quality of life. I hope this helped. All the best, Dr. Alma