A 20 yo male with PMH of anxiety presents with one week of chest discomfort. Symptoms began just after working out and have persisted since. At one point during his exercise, he noticed his apple watch show a HR of 260, associated with a few seconds of palpitations that resolved on their own. He attributes his symptoms largely due to anxiety as he has a history of this but just wanted to make sure it was nothing else. Denies dyspnea, lightheadedness, or syncope. He denies a family hx of sudden cardiac death or cardiac problems in general and does not take any medications or use any illicit drugs. He remembers similar symptoms happening twice before over the past year. He saw his primary care doctor for this who ordered an outpatient echo, scheduled for later this year.