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

### input:
I have been having arrythmias throughout the day. Examples are 103/59 pulse rate 103 waking, after nap 100/59 pulse rate 104. Pulse has been high as 135 and low in the same day in 40 and 50s. I have chest and back pain bit its more like pressure. Like something is sitting on my chest. I had possible tias back in march but no nerve damage. Ive had a problem with nerves causing muscles spasms but dont know whats causing itr. I wonder. If its whats causing thw arrythmia. Sorry my eys also are causing problems just typing. Thank you.

### output:

Hello Welcome to Chat Doctor. The heart usually beats rhythmically. Arrhythmias are irregular heart beats. Fast or slow heart rate but regular (rhythmic) as not called as arrhythmias. In your case it is not arrhythmias, it is just slow or fast heart rate called as bradycardia or tachycardia.  Your BP is on the list side but acceptable range. However, due to fast and slow heart rate intermittently throughout the day, chest pressure and history of Ties, I want you to undergo a cardiac evaluation with an ECG and a stress test. This tests can predict whether you have blockages in your heart. If both these tests come normal, and you still got similar complaints then you should do a Holder Monitoring in which a machine is attached to your waist with some leads on your chest and your heart rate is recorded continuously for 24 hours while you go about your normal day-to-day activities. This will show the heart rate disturbances you have and treatment can be offered accordingly. Please do the above tests and revert. Wishing you good health. Regards.