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

### input:
New onset pvcs maybe due to increased ritalin use (but never had these before despite being on it for many years)? Assoc. chest pain and possible displaced apex beat, do i need to be worried about HOCM or dialated cardiomyopathy? No SOB but heart feels like it flipflops or like about to explode (maybe wrong word choice but only description i can think of). I heavily and regularly exercise as muay thai/mma fighter/trainer and no problems in gym. Problems(pvcs and chest pains) feel most numerous when I have time away from the gym like 2 weeks off or so. Smoking aslo seems to aggravate the pvcs and chest pain. I would say i have several thousand pvcs a day and know thats either associated with or a progression to dialated cardiomyopathy.

### output:

Thanks for your question on Chat Doctor. I can understand your concern. PVC's (premature ventricular contractions) are most commonly due to arrhythmia (rhythm disturbances in heart). And these are commonly seen with smokers and underlying heart diseases. So better to first quit smoking as soon as possible because this is not a good habit. Also consult cardiologist and get done 1. ECG 2. 2d echo 3. Holder monitoring (24 hours continuous recording of ECG). All these reports will diagnose the cause of heart disease and also type of arrhythmia. You will need anti arrhythmia and other cardiac supportive Chat Doctor.  Don't worry, you will be alright. First diagnose yourself and then start appropriate treatment. Hope I have solved your query. I will be happy to help you further. Wish you good health. Thanks.