1) Get simple baseline tests once: TSH (with free T4 if abnormal), CBC, fasting blood sugar, vitamin D and B12, and an ECG. A normal set of these lets you stop worrying that it is your heart, which itself reduces the attacks. 2) During an attack, do not fight it — sit up, and use slow paced breathing: breathe in through the nose for 4 seconds, out slowly through pursed lips for 6-8 seconds, for 5 minutes. Remind yourself the surge peaks at about 10 minutes and always passes. Grounding (name 5 things you can see, 4 you can touch, 3 you can hear) helps break the spiral. 3) Sleep hygiene matters a lot for nocturnal panic: fixed sleep and wake times, no caffeine after 4 pm, no alcohol or heavy/spicy meals within 3 hours of bed, no phone/screen in bed, and keep the room dark and cool. 4) Daily 30 minutes of brisk walking or any aerobic exercise is genuinely as effective as medication for mild panic. 5) The definitive treatment for recurring panic is CBT (cognitive behaviour therapy) with a clinical psychologist — a short course of 8-12 sessions usually stops the cycle. If attacks are frequent or you start avoiding sleep, an SSRI prescribed by a psychiatrist works well; please do not start alprazolam or similar tablets on your own, as they help for an hour but cause dependence. 6) You can consult me on Practo to review your reports and to discuss whether you need medication or therapy first, or come to Synergy Multispeciality Hospital, Miraj, if you are in this region and would prefer an in-person check-up with an ECG.

Word of caution: do not simply assume every episode is anxiety. Seek emergency care if chest pain is crushing or spreads to the jaw or left arm, lasts more than 15-20 minutes, comes with sweating or vomiting, if you faint, if the heartbeat stays very fast and irregular after the episode, or if you wake gasping/choking repeatedly (possible sleep apnoea). Also seek help urgently if you ever have thoughts of harming yourself. Avoid self-medicating with sleeping pills or alcohol to get through the night.

feel free to consult me on practo for further evaluation and management

I can suggest u some tablets which can help you. Please get a consultation.