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

### input:
i am a 55 year old healthy active female, who, when feeling anxious suffers from palpitations and extrastole heart beats which seem to originate from the left hand side of the stomach. The more it happens the more anxious i become which then worsens the whole situation!! An echo cardiogram showed a v minor heart valve murmur considered to be of no issue. Could i have a hiatial hernia that is contribuitng to these uncomfortable senstations? what teatment is there? thankyou Cathy

### 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 palpitations 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. When you experience an extra systolic beat you might feel palpitation, difficulties in breathing deeply, anxiety, dizziness. There are different factors that might cause this skipped beats like emotional stress, excessive coffee or alcohol consumption, coca-cola, energy Chat Doctor. Pathology like anemia, hyperthyroidism, ischemic heart disease might be other causes. A hiatal hernia might also cause your palpitations, so It's mandatory to exclude all of these. If we found a cause than we have to treat it and resolve the problem. But a lot of times we do not find a cause. 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 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 and if it is necessary to treat them medically. If the rhythm holder monitoring results that you do have frequent extra-systoles than there are a lot of medications to control them. Hope I was helpful. Wish you good health. Best regards.