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

### input:
why do it feel like my heart is beating in my throat,i am 50 years of age,5"1 and weight 245lbs and i have high blood pressure ,last i check it was 144 over 112.I do take medication verapmil er 120mg every 12 hours,I also take fluoxetine for anxiety 20 mg once daily and sulfasalazine 500 mg twice a day.OH and by the way i am african american.

### output:

Hello! Welcome on Chat Doctor! I carefully passed through your question and would explain that your symptoms could be related to a cardiac arrhythmia. From the other hand anxiety could trigger this symptomatology. Your diastolic blood pressure values are significantly high and this means that your actual antihypertensive therapy is not very effective in controlling high blood pressure. Coming to this point, I would recommend consulting with your attending physician for a careful physical exam and performing some tests to investigate for the possible underlying causes: - a chest X-ray study- a cardiac ultrasound to examine your heart function and structure- an ambulatory 24-48 hours ECG monitoring to examine your heart rhythm trends during a prolonged time-complete blood count for anemia-thyroid hormone levels for possible dysfunction- kidney and liver function tests for possible dysfunction- blood electrolytes for possible imbalance. I would also recommend adding an ARB (Alsatian, losartan, etc.) to your actual therapy in order to have a better control of high blood pressure. You should discuss with your doctor on the above issues. Hope you will find this answer helpful! Best wishes, 