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

### input:
Hi, I am a 36 year old female, 5 5 , 143 lbs. I haven t been on *any* prescription drugs in years! About a year-and-a-half ago, I started experiencing heart flutterings, usually around night-time. My online research of the subject yielded sketchy results, so I decided to just work out more. I figured I was out of shape, though I usually eat healthy. And, I haven t experienced heart flutterings since then; but tonight, while sitting calmly at the computer, my heart constricted for about 5 seconds or less. It was a sharp pain, and I could feel it branching out (possibly nerves connected to heart?) and the sharp pain reached all the way to my back. My back now has a dull pain in the area right behind my heart. What could this be? I have neglected my workout routine, for the last six months. Thanks for your help.

### output:

Hello, Thank you for your query. Based on your symptoms I would like to rule out coronary artery disease and arrhythmias?* do you smoke or consume alcohol?* do you have any other medical issues like diabetes, thyroid disorders for instance? * any family history of high blood pressure and heart disease? Any chest pain must be immediately investigated. I recommend:- a physician consult right away- an electrocardiogram and echocardiogram- a treadmill stress test if indicated-blood tests (complete blood count, thyroid stimulating hormone, blood glucose panel, lipid profile, kidney and liver function tests)- 24 hr holder monitoring if required.- urine analysisBased on this a diagnosis can be made. Please do not continue your exercise routine till you have been cleared to do so by your doctor. Limit caffeine intake to a cup a day. Stay well HY Chat Doctor. Hope this helps. Please let me know if there is anything else I can help you with. Wish you good health