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

### input:
I m a 21 year old professional track sprint athlete. Yesterday(noticed by my girlfriend only) there was pulsation 2-3 inchs beneath my sternum(central but slightly to left if anything) and today I have had it much more noticably. I have been feeling a slight tremour in my whole body all day too(slight shakyness in hands). This evening the pulsation became very noticable almost like there was some sort of localised discrete cramp at that spot a few inches below my sternum. I also feel almost pulpitations in my heart too (I do have a grade 1 heart murmur). A little while ago as I was laying back pushing out my chest a little I got a strong cramping pain in the heart area that lasted a few seconds then went but have had tightness since then(it has died down a little now). I don t want to have to go in to have it seen to if not neccessary but just wondering what this could be? Note that I did very heavy weight bearing exercise today(squating etc.) and was also very cold a few days ago for a few hours(whether that makes a difference due to thickening of blood as I once saw in some program!!). Any help is much appreciated!!! Thanks, Benjamin Reynolds (Northern Ireland)

### output:

Thanks for your question on Chat Doctor. I can understand your concern. No, these symptoms are not due to thickening of blood. Since you are having heart murmur, we should definitely rule out arrhythmia (rhythm disturbances in heart) in your case. So consult cardiologist and get done 1. ECG 2. 2d echo 3. Holder monitoring (24 hours continuous recording of ECG). If all these are normal then no need to worry about arrhythmia or other heart diseases. Sometimes uncontrolled stress and anxiety can also cause similar symptoms. So avoid stress and tension, be relaxed and calm. Don't worry, you will be alright. But first rule out heart diseases like arrhythmia. Hope I have solved your query. I will be happy to help you further. Wish you good health. Thanks.