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

### input:
my heart beats fast, sometimes hard, skips, or flip flops. I get very very tired. So if I am sitting which I often have to when my heart does this, I can instantly fall asleep. even as typing this I could just close my eyes and drift. Also, slong with these feeling it is also difficult to breath at times. I find that when this is happening I begin to try and calm down so not to panic and to just relaz so that maybe the rest will also relax.

### output:

Hello and thank you for using Chat Doctor. I carefully read your question and I understand your concern. I will try to explain something and give you my opinion. I think these symptoms seems to be related with a heart rhythm issue. You should know that the heart has her own electrical system. The electrical impulse passes through the heart and makes it to contract and function normally. There are some pathologies of electrical system of the heart that might cause arrhythmia and heart electrical pauses. The symptoms of this kind of pathologies are palpitations, skipping beats fast heart beats, difficulties in breathing deeply when the heart experiences arrhythmia and then other symptoms like feeling tired or losing senses in bradycardia or electrical pauses. To diagnose this rhythm problem it is necessary to do some examinations. So, if I was your treating doctor I will recommend doing an electrocardiogram, a cardiac echo, a fool blood test and the most important one holder rhythm monitoring for 48 h. This examination gives us the chance to monitor your heart rhythm as you feel tired, sleepy or experience heart racing. Only after this my can know what we are dealing with and how to treat it. Hope I was helpful. Wish you good health. Best regards.