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

### input:
Hello, I am a 43 year old African-American female with a history of high blood pressure, and pre-diabetes. I have been experiencing VERY frequent intense heart palpitations, that can be felt in my chest, a fluttering in my throat and a sense of heaviness, lethargy, lightheadedness and mild shortness of breath at times, VERY frequent and irritating burping and belching. I feel as though I m having hundreds of palpitations/flutters per day, onset 5 days ago, usually noticeable while laying down and sitting upright. I have been taking Bisoprolol 10/6.5 for approximately 2 years and the palpitations that I was having at the time I was prescribed stopped for the past year and have now resurfaced. I also had a history of reflux/GERD and I tend to have some relief of the palpitations with a huge belch. I am not so much concerned about the GERD symptoms as much as I am with the fluttering and palpitations, which seem much more intense than before. Could the palpitations be associated with GERD?

### output:

Hello, Brief answer: No direct relation between both conditions. Palpitations need to be checked. Explanation: My opinion is that your palpitations are a cause of concern here as it causes low blood pressure in your case (lightheadedness, lethargy) and so you need urgent visit to your cardiologist. Eructation is a maneuver that may terminate some palpitation by vagus nerve stimulation. I suggest my patients the following EKG, chest x-ray and an echocardiogram as a start, I may sometimes order a Holder monitoring which is basically a 24 to 48 hours record of heart rate rhythm. Conclusion: I suggest you check your cardiology specialist as soon as possible. Hope I have answered your query. Let me know if I can assist you further.