I was wondering if anyone has experienced anything similar to what I've been experiencing for the last week. Any comments and suggestions will help. Thank you!

My anxiety/panic attacks are mostly preceded by the events of frequent skipped heart beats which triggers a coughing reflex, which throws off my breathing rhythm and at the same time builds up nausea, and the change of breathing rhythm induces a higher chance of another skipped heart beat. All this is like a loop that ultimately leads to a very quick increase in anxiety levels mostly from fear of death, especially when I do vomit during these series of events, which is what happened yesterday and last Wednesday. Yesterday was worse because I threw up a lot of food while having the episode so that made breathing even more difficult which adds to the likelihood of having another skipped beat.

Usually what triggers my skipped heart beats to begin with are alcohol, very deep and quick breaths from exercising, or the fact that my breathing rhythm is constantly changing since my nose can be in one of four states at  random times (left and right nose not stuffy, only left stuffy, only right stuffy, or both stuffy) since I have a diagnosed sinus issue which does do this. So I’m either mouth breathing 100%, or mouth breathing 50% left/right nasal 25% each, or mouth breathing 25%, left nasal 25%, right nasal 50%, etc. etc. There’s a lot of different unique breathing states that go through and this is significant enough to induce a skipped beat (not anxiety related).

After the occurrence of the episode, my anxiety levels remain elevated because now I'm always conscious about every single inhale/exhale, trying to regulate each breath. This causes me to worry that if I don't regulate the next breath properly then that might ultimately lead to the episodes again. Most, if not all, of this phase is mental.