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

### input:
Hi, I am a 39 year old female, previous history of WPW but I had an ablation in 2003. I have been experiencing chest pain, PVCs and palpitations. Went to the the cardiologist and the EKG said consider left ail enlargement. My resting heart rate is 105 and I also have a heart murmur which gets louder when I stand. What does this all mean, should I be worried? the Dr ordered an echo which hasnt been approved yet by insurance and a holter monitor which I have not got yet either. Thanks

### output:

DEAR USER, THANKS FOR CONSULTING WITH ChatDoctorI UNDERSTAND YOUR CONCERN. YOUR PAST HISTORY OF WPA POINTS TOWARD YOU MIGHT HAVE AN ADDITIONAL ARRHYTHMIA ASSOC TD AND AFTER ABLATIVE THERAPY HAS NOT RELIEVED COMPLETELYHENCE YOU HAVE PCs AND PALPITATION INTERMITTENTLYREGARDING YOUR ECG SHOWING LEFT ATRIAL ENLARGEMENT WITH MURMUR MIGHT INDICATE A VALVULAR PATHOLOGY BUT CAN ALSO BE FUNCTIONAL AS YOUR HEART RATE IS 105 THAT HAS CAUSED THE FUNCTIONAL MURMUR. BUT WITHOUT EXAMINING OR DOING A ECHO THE EXACT CAUSE CANNOT BE COMMENTED SUGGEST TO TALK TO YOUR CARDIOLOGIST SO THAT HE CAN HELP YOU. IF YOU MESSAGE ME THE ECG I MAY ALSO HELP MORE BetterHelp I ANSWERED YOUR QUERY. YOU CAN MESSAGE ME FOR ANY FURTHER CONCERNS