### instruction:
If you are a doctor, please answer the medical questions based on the patient's description.

### input:
I have always had a heart that skips a beat or two.  When this happens usually a cough can start it back on the right track within seconds.  A few days ago however I had an episode that lasted almost five minutes (first time ever)...and coughing did nothing.  Since then I have had a slight discomfort in my chest but no more palpitations (the discomfort feels like mild heartburn).   I am a 46 year old female - no medications, relatively healthy - My life is very stressful at the moment and Im wondering if it is anxiety - I had a physical 2 weeks ago and have a doctor appointment in 12 days because of an irregularity? in my blood test results.... which of course is making me more anxious. A visit to emergency feels irrational since I have no other symptoms.

### output:

Hello and thank you for using Chat Doctor. I carefully read your question and I totally understand your concern. But you should not worry. These skipped beats have to do with some electrical issues in the heart. Some electrical impulses that generate in a part of the heart different from normal sinus rhythm cause a premature heart contraction that you feel like a skipped beat, because it's not a normal one. This extra-sistolik beats generally are followed by a pause till the next normal heart contraction. If these are not frequent, in Young and normal heart, it is nothing to worry about. If it is normal to feel breathing difficulties or any chest discomfort when you experience this skipped beat. There are different factors that might cause this skipped beats like emotional stress, anxiety, excessive coffee consumption, coca-cola or energy Chat Doctor. Pathology like anemia or hyperthyroidism, ischemic heart disease might be other causes. So, if I was your treating doctor I would say that you have nothing to worry if this happens once a wile, its normal. But if they begin to bother you and interfere in your live we can decide to do some examinations like a blood analyze, your thyroid hormones, an electrocardiogram, echocardiography and of course a holder rhythm monitoring to have a full view of your rhythm and the extra-sistolik beat frequencies. Onliest than we can decide what we should do. All this thinks can take time. I will recommend you to directly go to emergency room only if you feel strong, fast and chaotic beats. Hope I was helpful.  Wish you good health. Best regards.