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Most of your symptoms sound typical for a panic attack. The nervousness, chest discomfort, tingling, nausea, and lump in the throat all sound consistent. The urgency to use the bathroom isn't a typical symptom but everyone does not experience a panic attack the same either. General feeling as though you are about to die is the general theme of this entity. This sounds consistent with your symptoms. I would advise you to follow up with your doctor at first chance. It may be that you could benefit to increase your dose of xanax in order to help prevent future attacks. (DO NOT CHANGE YOUR DOSE WITHOUT YOUR DOCTOR DIRECTING YOU TO.... as this will only get you in trouble) You might be on a high dose now. The Xanax should help tom prevent panic attacks but nothing is ever 100% in this regard to those whom are susceptible to these. The Celexa is also useful with this anxiety disorder.
I hope this information helps somewhat. Further questions are welcome if you have others. If my answer has been helpful and to your satisfaction then please remember to press the "ACCEPT" button. Thank You and Best Regards,
Anthony Bray MD
A heart attack would not be as likely to have the widespread symptoms. The light headed feeling and tingling are probably due to hyperventilation that commonly occurs with panic attack. As you hyperventilate you decrease the carbon dioxide in the blood and this changes the pH of the blood and makes you have the tingling sensations(paresthesia) and the light headed sensation. These are not typical with angina or heart attack. Of course actual cardiac symptoms in a person prone to panic attacks may very well provoke so it is a tricky question. One thing in your favor is your age. It is very unusual for a person your age (especially female ) to have a heart attack but it isn't impossible. I see that you do have risk factors with your high blood pressure and high cholesterol. I hope that you don't smoke! ((The Crestor is an excellent choice for treatment by the way ... the BEST in my opinion))
Panic attacks typically settle down in about 30 minutes. In the end I would say that you have to leave it to common sense and to use your best judgment. It is often best to play it safe. That being said I doubt that your symptoms are cardiac in nature but much more likely to be panic attack in nature. The overall picture seems to fit with panic attack rather than cardiac.
I hope this helps. Further questions are welcome if you have others. Best regards,