<s>[INST] I just turned 22 yesterday. Over the past year, Ive gained 80+lbs. Recently when I wake up, my heart is pounding so hard it feels like its in my throat, my ears are ringing, and I feel pressure/pain in the back of my eyes. Im a black female and heart disease runs in the family. So what could my symptoms be related to? [/INST] Hi, Increased heart rate & palpitations can have a lot of causes. It can be normal sinus tachycardia due to anxiety or stress, or it could be abnormal supra ventricular tachycardia. For the diagnosis, you need to do ECG at the time of palpitation & tachycardia. If the duration of palpitations are short enough to reach a nearby hospital, we put a 24hr ECG monitoring (Holder Monitor). You also need to do a 2D Echo & thyroid function test to see for any associated abnormality if any. Treatment will be as per report. Thanks </s>