What Causes Lightheadedness, Nausea And Tingling In Shoulder Blades?

32 yo female. Past week and a half, have had random bouts of lightheadedness and nausea. The nausea comes first. Lasts for about 30 minutes if I lay down. This evening, I think I almost passed out. I am also having a tingling/ really weird feeling g pain in my shoulder blades (this has been on and off for a while) seems to get worse during these spells. I do have panic attacks. This is not a panic attack, though feels like it could start one. My heart starts to beat rapidly, and I get clammy. E.r? Or wait until I can get appt?