Oh I have an algorithm for troubleshooting this that I use for my psych patients but it does still require one initial doctors assessment the first time it happens to rule out cardiopulmonary causes. ~~I'm on my phone so I can't type it out right now though and I won't have time to until later tonight.~~ It's how to make sure it's still just anxiety and that it hasn't turned into a heart or lung problem (there's also a secret third thing!).

ok so if you have chest pain or shortness of breath you go get that checked out the first time. And this is separately like if you got your chest pain checked out then later you have shortness of breath, you go get the shortness of breath checked out. But if you're having the same symptoms you've had checked out before and you're just thinking to yourself "but what if this time it is something???" Here's what you do.

1. Call a friend and either ask them to come hang out or just tell them your address and ask them to stay on the line with you for a bit.

2. Engage in some kind of light physical activity that is either mundane or pleasant and takes your mind off the discomfort. So fold clothes while chatting with the friend, or go for a walk while talking to them. If the pain doesn't go away or especially if it gets worse with physical activity, then you go get it checked out. And if it's real bad and you become incapacitated, the friend can call an ambulance for you. But the most likely thing that will happen is that when you're distracted and the movement gets your blood and respiratory system lightly circulating, the pain will go away.

3. The secret third thing is heartburn / acid reflux. If you start having chest pain that's a little more on the burning side, or especially if it happens right after you've eaten junk food or when you haven't eaten in a while or in the morning right before or after breakfast (basically some kind of food-related pattern) try some pepto or tums, or if you don't have those, try some 0% fat / skim milk (any fat would digest into more acid, the aim is to just use the water and calcium). Cold water on it's own also isn't a bad option. Anxiety is actually a super common heartburn trigger for people who have both, and people who have had legit heart attacks sometimes get the sensations confused. I actually get a fair number of patients reporting chest pain that gets written off as anxiety when it's found to be non-cardiogenic, and even a lot of healthcare professionals forget to also rule out gastrointestinal causes.

Hope this helps!