Prolonged palpitations near heart attack at 26 years old

[J3K]

I am a 26 year old male, 6ft 142lbs athletic. I'm not the healthiest person around, smoked cigarettes on and off for 2 years- currently quit.
I've had minor episodes of palpitations in the past but didn't think much of them.
Recently I was at my friends house and my heart slowly started to increase. I was calm and didn't think I was having an anxiety attack- never had one. I started getting worried when I feel like I was going unconscious and my heart was at the 160. This happened over the course of 30 minutes.
I wanted to avoid the ER (not insured) and I let myself try to calm down but my heart rate increased to 180/190 and I was having chest pain. My whole body was going into spasms, lost feeling in feet and hands.
I continued laying down and suddenly the spasms stopped. My heart slowed down and I felt a SHARP pain move its way down my sternum and slowly outward from my heart into my left arm. My left bicep was cramping like hell and my left lower side abs were cramping painfully.
This is when I finally got someone to drive to the hospital- 3 blocks away...
I got there heart at 192. They injected my with Atavan and did an ecg/ X-ray of my chest.
Nothin abnormal in the charts except low potassium and high blood sugar at the moment. They said I would have had a hear attack if I didn't make it in time.
Felt symptoms for a week or so but I'm somewhat back to normal now.
People tell me it was from stesss by I think possible mitral valve prolapse

[J3K]

Yes, I started smoking as an adult, quit for a few years and started again. I had very recently quit smoking but switched to an ecig before the episode.
I've been under stress lately (moving, car wreck, financial. Etc.) but Ive never had an "anxiety attack". Never been on meds but I do use marijuana. Medical card holder in the state of Colorado. I've never had adverse reactions to marijuana or any other drug.
I am extremely sensitive to caffeine and hardly used it anyway.
It's weird because I stayed very calm and never thought I was panicking, until I started tracking my heart rate and having spasms.
Thanks for the input, I was thinking about an ultrasound of my heart and I will look into the stress ecg.

[ScalpMassager]

Ativan's a potent anti-anxiety med.  Perhaps that was your first high anxiety attack.  Have you had earlier periods of feeling generally anxious, perhaps to the point of it sometimes affecting your quality of life?

Did you start smoking as an adult (~age 24)?  Had you just stopped smoking (again) prior to this episode?  Discontinuing nicotine abruptly can greatly heighten nervous tension and trigger anxiety, perhaps severe anxiety when combined with some other stressor such as a social setting, in anyone predisposed that way and untrained in coping methods.

A supervised treadmill stress test (where you're hooked up to an ECG), would help uncover any heart defects you may be contending with [that ought not be extraordinarily expensive, less than the actual cost for an ambulance ride in most areas imo].  A resting ECG merely records the heart's activity at rest and without any challenges.

I suspect a high anxiety episode may have been stressing your heart in such a way as to expose a heart defect.