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

### input:
For several months I have had this feeling in my heart like someone is poking their finger on it. It comes and goes. Sometimes wakes me in the night. I am 54, in great shape, very active. A year ago I went on Synthroid for Hypothryodism. I have no other problems

### output:

Hello and thank you for using Chat Doctor. I carefully read you question and I understand your concern. I with try to give you my opinion and advise. You should know that a typical heart pain usually has some characteristics. They are retro-Sternal pains like tightness, squeezing that last from 5 to 20 minutes. They might irradiate to both arms, neck and jaws. Pains like poking a finger that comes and goes its not typical heart pain. It might be skeletal, muscular or neurotic pain. This poking sensation might be a heart rhythm issues. 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 or like someone pokes you. There are different factors that might cause this rhythm issues like emotional stress, excessive coffee consumption, coca-cola or energy Chat Doctor. Pathology like anemia or hyperthyroidism might be other causes. So, if I was your treating doctor I would say that you have nothing to worry if this happens once a wile, its normal. But if this begins to bother you and interfere in your live we can decide to do some examinations like a blood analyze, your thyroid hormones as you had problems ones, an electrocardiogram, echocardiography and of course a holder rhythm monitoring to have a full view of your rhythm. Only than we can decide what we should do. Hope I was helpful. Wish you good health Best regards.