Hi. It’s unsettling to experience pounding at lower to normal heart rates. I have andrenergic POTS (with bradycardia and PVCs) with asthma. I also have Sjogrens with laryngeal involvement. As aside I have EDS (Ehlers Danlos) and small fiber neuropathy as well. The pressure up into your upper chest and throat is familiar to me. I’m so adrenergic that my larynx is extremely sensitive at this point. I’ve been mostly without the ability to speak well for two years. Every time I wake up from sleeping I experience a huge adrenaline dump that induces pounding, sweating, and spasms up into my larnyx. I take Metoprolol 25mg two (or three times a day if I’m in a surge), Low Dose Naltrexone (2mg/day), and I just started Mestinon. Going very slowly with it to minimize side effects. I’m only up to 60 mg at night. I take other meds for my eyes and my asthma, but the struggle to deal with runaway sympathetic activity is ongoing with big setbacks for me. 15 days ago I had a big adrenaline event that caused dehydration and chest pain that put my pretty much flat for 5 days and not back to baseline even now at 15 days. It’s a bit like a reorganization of self. I hope you find some relief.