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

### input:
i am 40 year old male.   I have had pericarditis 7 years ago and I have a murmur that developed around the same time.   I have been feeling pretty run down lately, heart rate stays higher, 100-120 bpminuteI am a fairly fit individual, 160lbs and activethis weekend my blood pressure has been higher   156/96

### output:

Hello and thank you for using Chat Doctor. I carefully read your question and I understand your concern. I will try to explain and give you my opinion. There are different reasons that might cause increased heart beats. Physical or emotional stress, caffeine products might cause increased heart frequency so It's mandatory to avoid them. All sow, there are different pathologies like anemia, thyroid gland problems like hyperthyroidism that might be the cause of fast heart beats.  We talk about hypertension if we have mean values exceeding 140/90 mmHg. We divide it in two groups, essential hypertension without identifiable cause and secondary hypertension meaning that it is a secondary disease cousin it is like renal disease, endocrine problems' ect. This high frequencies and blood pressures might be the reason that you feel a little down. So my opinion is that we have to do a full check up. If I was your treating doctor I will ask to do an electrocardiogram, a cardiac echo to evaluate that previous murmur that you say and the pericardium again, a rhythm and a blood pressure holder monitoring for 24 h to evaluate your real frequencies and pressures during day and night. All sow a blood analyze to exclude anemia, your thyroid hormones, your urinary catecholamine and an abdominal echo to see the renal situation. After all this results we can have a full view and decide if we should treat these things or not. Hope I was helpful. Wish you good health. Best regards