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

### input:
I am taking 2.5 Ramapril, 2.5 Bisoprolol, 10 Prasagrel.  I had a STEMI July 12, got emerg stent in LAD.  Trop was .25 (it was .01 4 days later).  T was inverted until ECG on 09/19/2012 then resolved to normal ECG.  What causes sensation of pounding heartbeat o

### output:

Hello and thank you for using Chat Doctor. I carefully read your question and I understand your concern. I will try to explain you something and give you some advises. My opinion as cardiologist is that we are dealing with a rhythm issue. You might experience fast heart beats or pounding sensation for different reasons. It may be a simple sinus tachycardia. This mean that your heart beats over 100 beats for minute. Its normal range should be between 60-100 beat for minute in resting situation. It may happen for different reasons from simple emotional stores to different pathologies like anemia, hyperthyroidism etc. This pounding sensation might happen because of extrasistoles.These is electrical impulses that generates from different parts of the heart different from that of a normal sinus rhythm. This houses an ectopic heart beat that you feel like a skipped beat or as a palpitation Extrasistoles might happen for the same reasons as sinus tachycardia. All sow that might be frequent in ischemic heart disease or in patient after a heart attack because of changes of the heart muscle. In fact, you take medications to prevent this rhythm problems. Bisoprolol is a medication that gets down your heart frequency and extra systolic beats. But if you feel your fast heart beasts and this begins to interfere with your normal daily life it means that the medication might be insufficient. So, Bisoprolol helps you not to feel this heart beats but if you do, it means that you need to do a simple check up to see what's happening with an electrocardiogram and a holder monitoring. After judging the results we might talk for the treatment Hope I was helpful. Wish you good health. Best regards