<s>[INST] For years, I periodically have some heart palpitations with tightness in the center of my chest. Heart test show not much going on, I just deal with them when I get them. Today however, I had a MRI for my lower back. I felt fine during the test but afterwards my chest ached. Similar to esophageal spasms, but I also had heart palpitations. My heart rate is about 120-134 bpm and I keep needing to deep sigh breathe every five minutes or so. I am 61 and was just sitting watching TV when I finally was concerned enough to check. I also have been hearing my heart pound below my ears on and off for the last month or so. I have a follow up with my Heart Dr. But not until Middle of July. Do I need to be concerned about this today? [/INST] Hi Welcome to HCM.I understand your query and concern.Rapid heart rate and Dizzy spells can be a definite feature of heart rhythm disturbances.Irregular heartbeat is known to alter the blood supply to the brain leading to impaired function in a transient way.Few drugs like beta blockers are certainly known to reduce the heart rate and accelerate the dizzy spells.I advise you to have a complete 24 hour holter ECG which can accurately determine the cardiac conduction abnormalities.Monitor your blood pressure and heart rate.Drugs like Isoproterenol will help to increase the heart rate.Drugs like amiodarone can also help to minimise the rhythm irregularities.A 2 Dimensional echocardiography will help to assess the functional reserve of the heart ruling out organic heart lesions.Electrophysiological study and Radiofrequency ablation will also help to eliminate abnormal foci of rhythm.Consult your cardiologist for expert management.Post your further queries if any,Thank you. </s>