<s>[INST] hi, i am 4 months pregnant, and i have been experiencing heart palpitations, chest pain and pain my left arm. Mostly just pain in my left arm. I have been through the routine check for heart disease, which included a heart echo, and ekg s and have been seen by the top cardilogists in toronto, ontario. I can t seem to figure out what is wrong with me. Other doctors that i have been to said that there can possibly be a problem with anxiety, like an anxiety attack but I really and truly feel that this is not the problem. I am worried for my unborn child, which is not my first. I have never had any problems with my previous pregnancy, so I am wondering what is wrong with me. please help [/INST] Hello, If your ECG, Echocardiogram have not revealed any abnormal finding, the next step would be to go for holder monitoring to record what exactly is going wrong whenever you experience the palpitations. It is common to miss important findings in a random test. The possibility of anemia, stress and general infection also should be considered and appropriate investigations ordered. Analysis of holder monitoring findings usually helps to sort out the problem. Meanwhile, take adequate rest preferably in left lateral position, maintain good diet and avoid stress. Hope this helps. </s>