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

### input:
my heart flutters and feels like someone shot a needle full of gas directly into my heart... it flutters especially when i lay down or on my left side... It scares me bad.. during day it happen not that oftens..its like i have to "cough" to make it sort of skip back into beat.

### output:

Hello, There are two possibilities, one is gastritis and reflux disease and second is cardiac arrhythmia.  It can be an acidity and reflux disease. Do you upper abdominal pain, nausea, bloating, burping, increase in pain on food, sour water feeling in throat or chest burning, if yes it further supports the diagnosis? You should avoid fatty, oily and high calorie diet. Have some walk after having food instead of taking rest. Have multiple small meals instead of heavy meals. Have regular sleep habits and avoid stress. Lots of green leafy vegetables, fruits. Avoid smoking and alcohol if any. You can get prescribed tab Pan DSR 40 mg before breakfast once a day for 2 weeks.  If none of the above symptoms are present, then there is a possibility of cardiac arrhythmia like PSV or atrial fibrillation, in which heart rate suddenly goes up and also suddenly decreases. Blood pressure falls during these episodes and one has dizziness, fainting, blackouts, sometimes syncope. Usually ECG is normal as it is usually done in between the episodes. ECG done during episodes will show abnormality. You will need 24 hour holder monitoring. So visit nearby cardiologist for this investigation. Ln order to abort such episodes you should try to cough hard. Till the time your evaluation is complete, you can ask your local doctor for tab collar LA 20 mg once a day.