<s>[INST] Hello Dr.Samuel N.Grief,i want to know what it means when you feel like there is like a knot feeling in your heart and it feels like its twisting its a bit painful and happens to me almost ever other day and on those days i have it continuously throughout that day? [/INST] Hi Welcome to Chat Doctor, I understand your concern. Your symptoms could be related to underlying pathology in the heart. So I advise you to get an ECG,2D Echo, lipid profile immediately. Monitor blood pressure and heart rate immediately. Chat Doctor. Exercise daily for 30 min. Avoid smoking and alcohol if any. Consult cardiologist for expert management. Post your further queries if any, Thank you. </s>