Conversation: The conversation between human and AI assistant.
[|Human|] A patient is complaining of a shocklike sensation in the left precordial area (breast) lasting for several seconds. It is on/offf, and more frequent when active. He has a pacemaker (not new), and interogation showed no problems. What is the etiology??
[|AI|]  Hello and thank you for using Chat Doctor. I carefully read your question and I understand your concern. I will try to explain you something and give my opinion. This shock like sensation has to do with a rhythm issue. There are some electrical impulses that generates from parts of the heart different from normal sinus rhythm. They cause a premature heart contraction that it's not a normal one. This electrical issues might be extra systolic beats, atrial fibrillation or different arrhythmia. In these cases a person might experience a palpitation, flattering or shock like sensation. This might happen even in a patient that has a pacemaker. The pacemaker is a safe battery in cases when the heart rhythm falls down. The pacemaker might function very well and the patient might experience arrhythmia. This rhythm issue might have different causes like simple emotional stress to different pathologies like anemia, hyperthyroidism, active infections, ischemic heart disease. So, if it happens once a wile it is nothing to worry about. If it persists, if I was the treating doctor I will recommend some examination like an electrocardiogram, a cardiac echo to evaluate heart function and the most important one a holder rhythm monitoring to see what happens with the rhythm during day and night. Hope I was helpful. Best regards.