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

### input:
i am a 44 yr old male pack a day smoker, no family history of major health issues, i do not drink or do drugs, i am on my feet 8-10 hrs a day, ive never had any health issues and i dont exactly eat the way i should, i am around paint and some chemicals on the weekends and i dont have a doctor that i see.every now and then i get a thump or fluttering in my stomach and chest area and i cant seem to exhale and for a second i lose my breath entirely and honestly it really scares me. any thoughts on what may cause this and am to young to have developed emphasema pr to old to develope asthma ? please help

### output:

Thanks for your question on Chat Doctor. I can understand your concern. By your history and description, possibility of arrhythmia (rhythm disturbances in heart) and COPD (chronic obstructive pulmonary disease) is more. Fluttering sensations in chest are mostly due to arrhythmia. And arrhythmia is common in smokers. So consult doctor and get done ECG, 2d echo and Holder monitoring (24 hours continuous recording of ECG). If all these are normal then no need to worry about arrhythmia or other heart diseases. You are also having breathlessness. So chances of COPD (emphysema or bronchitis) is also high as you are a active smoker. Smokers are prone ti develop emphysema after the age of 40 years. So at 44 years of age, you are at risk of developing emphysema.  So consult pulmonologist and get done clinical examination of respiratory system and PFT (pulmonary function test). PFT will not only diagnose COPD, but it will also tell you about severity of the disease and treatment is based on severity only. You will improve with inhaled bronchodilator and inhaled corticosteroids (ICS). In any case, quit smoking as soon as possible. Hope I have solved your query. I will be happy to help you further. Wish you good health. Thanks.