<s>[INST] Hi doctor i am haemophilia patient age 20 currently i ve been having this wierd sense of my heart beat like i can feel my veins beating to that heart beat my heart beat is normal but its more like its loud or beating heavily recently ive been having this worries about my visa medical exam i wonder if this is anxiety but I have one question is it common for a haemophilia to get Heart attacks specially my age [/INST] Hello! Welcome and thank you for asking on Chat Doctor! I read your question carefully and understand your concern. Regarding your concern, I would explain that hemophilia is not relate to heart attacks (which are thrombotic events) but to repeated episodes of hemorrhage. This disorder affects coagulation factors, resulting in an imbalance of coagulation, leading to spontaneous hemorrhages in all the parts for the body. Some studies have suggested that hemophilia is a protecting factor against coronary artery disease, but many studies have concluded that hemophilia patients have the same cardio vascular risk as other healthy persons. So there is nothing to worry about a heart attack at your age. Your symptoms may be related to anxiety. But I recommend consulting with the GP for a careful physical examination, to exclude other possible complications of hemophilia (internal hemorrhage or brain hemorrhage). Further tests may need to be performed if suspicions are raised. Hope to have been of help! Best wishes,  </s>