<s>[INST] For several months I have had this feeling in my heart like someone is poking their finger on it. It comes and goes. Sometimes wakes me in the night. I am 54, in great shape, very active. A year ago I went on Synthroid for Hypothryodism. I have no other problems [/INST] Hello and thank you for using HCM.I carefully read you question and i understand your concern. I with try to give you my opinion and advise.You should know that a typical heart pain usually has some characteristics. They are retro-Sternal pains like tightness, squeezing that last from 5 to 20 minutes. They might irradiate to both arms, neck and jaws. Pains like poking a finger that comes and goes its not typical heart pain. It might be skeletical, muscular or neurotic pain.This poking sensation might be a heart rhythm issues. Some electrical impulses that generate in a part of the heart different from normal sinusal rhythm cause a premature heart contraction that you feel like a skipped beat or like someone pokes you.There are different factors that might cause this rhythm issues  like emotional stress, excessive coffee consumption , coca-cola or energy drinks, so you have to avoid them.Pathology like anemia or hyperthyroidism might be other causes. So, if I was your treating doctor i would say that you have nothing to worry if this happen once a wile, its normal. But if this begin to bother you and interfere in your live we can decide to do some examinations like a blood analyze, your thyroid hormones as you had problems ones, an electrocardiogram, echo-cardiography and of course a holter rhythm monitoring to have a full view of your rhythm.Only than we can decide what we should do.Hope I was helpful. Wish you good health Best regards. </s>