The symptoms you are having, particularly the chest pains, do occasionally go along with a heart problem. However, it seems like you have had that worked up pretty well, so the likelihood is lower that this is related to your heart.
Panic attacks and anxiety
disorder can also definitely cause these types of symptoms. If, despite being on medications, you are still having symptoms, then it is probably time to talk with your psychiatrist
again to see if any changes to your medications should be attempted.
Also, it is important to point out that smoking cigarettes is almost certainly making your symptoms worse. I would strongly suggest that you talk with your primary care doctor
about quitting smoking, because reducing or eliminating your nicotine intake could help the twitching symptoms and also relieve some of your anxiety-related complaints. These days, there are many effective approaches to quitting smoking, which include counselling, nicotine replacement, and other medications. Some of these medications are also used to treat anxiety, so you might be able to settle on a new medication that could help you both quit smoking and also treat your anxiety.
Talk to both your primary care doctor and your psychiatrist as soon as you can.