<s>[INST] I have flipflop, thumping heartbeat or fluttering under right & left rib cage. It is there more often after I have my strong chest pains, [which I get every two days or so]. I have rheumatic heart disease, so just wondering if this is the cause?? At least I ll be rest assured then. Thankyou in advance. [/INST] yes. . ur right. . R H D might have damaged ur heart valves so badly that ur heart is strained to pump ur blood. . get immidiately 2D ECHO done and consult ur teatime cardiologist without any delay </s>