<s>[INST] I had a recent EKG which showed 1 early beat. My chest X-ray, oxygen, and blood pressure were all normal. He heard a slight wheeze. I ve been experiencing a weird pulsing sensation in my throat which sometimes feels like a strong heartbeat which catches sometimes causing a cough. My throat also feel like there is pressure on it or a lump in my throat. I ve been experiencing some tightness in my chest and reflux. Is this heart related or reflux related? [/INST] Thanks for your question on Chat Doctor. Yes, you are right. This can be due to reflux related more. Since your other reports are normal, possibility of reflux disease is more. One early beat on ECG can be seen normally and will cause many symptoms. But better to rule out cardiac cause for your symptoms. So get done 2d echo and stress test to rule out Cardiac cause. If both are normal than no need to worry much for cardiac cause. It is reflux disease related mostly. So avoid hot and spicy food. Avoid stress and anxiety. Start proton pump inhibitor. You will be alright. Don't worry. </s>