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

### input:
I often feel heart palpitations at night when I lay down to go to sleep. It doesnt happen every day but maybe once a week. When this happens, the more I think about it the more I notice it. It feels as if my heart skips a beat. I normally dont notice it during the day. I also sometimes have a pain in the left side of my neck, not severe just a dull ache, that can sometimes be relieved by moving my head. I do notice this more when Ive had a stressful day or when Im worried about something. Should I be concerned?

### output:

Hello and thank you for using Chat Doctor. I carefully read your question and I totally understand your concern. But you should not worry. These skipped beats have to do with some electrical issues in the heart. Some electrical impulses that generate in a part of the heart different from normal sinus rhythm cause a premature heart contraction that you feel like a skipped beat, because it's not a normal one. This extra-sistolik beats generally are followed by a pause till the next normal heart contraction. If these are not frequent, in Young and normal heart, it is nothing to worry about. There are different factors that might cause this skipped beats like emotional stress, excessive coffee consumption, coca-cola or energy Chat Doctor. Pathology like anemia or hyperthyroidism might be other causes. The pain in the neck, relived with changing position is not related with the palpitations. It might be related to muscular or cervical problems. So, if I was your treating doctor I would say that you have nothing to worry about the palpitations if this happens once a wile, its normal. As you say, they might just be related to stress. But if they begin to bother you and interfere in your live we can decide to do some examinations like a blood analyze, your thyroid hormones, an electrocardiogram, echocardiography and of course a holder rhythm monitoring to have a full view of your rhythm and the extra-sistolik beat frequencies. Onliest than we can decide what we should do. Hope I was helpful. Best regards.