Conversation: The conversation between human and AI assistant.
[|Human|] Hello . I am 6 5 slender build . I have been noticing that when I lie down at night my heart will miss beats . Then when the next beat comes its much harder almost like I m getting punched . It happens every 10-50 beats and is starting to scare me . It almost feels like my heart is stopping then starting very violently.
[|AI|]  Hello! Welcome and thank you for asking on Chat Doctor! Your symptoms seem to be related to ectopic heart beats or possible cardiac arrhythmia. Do these symptoms occur only at night? Have you noticed any similar troubles during the day? Are your symptoms associated with difficulty breathing, changes in blood pressure or chest pain? Anxiety could also mimic this clinical situation and would explain the fact that you notice this only at night. I recommend consulting with your GP for a careful physical examination, a resting ECG, a chest x-ray and some lab blood tests (complete blood count, fasting glucose, kidney and liver function tests, blood electrolytes, thyroid hormone levels, etc.). An ambulatory 24-48 hours ECG monitoring and a cardiac ultrasound would be necessary to rule in/out possible cardiac arrhythmia if suspicions are raised. But, if all the above-mentioned tests result normal, the main cause of this clinical symptomatology would be just pure anxiety. In such a case, you should discuss with a specialist of this field to help you manage your anxiety. I would also advise reducing caffeine intake and perform a lot of physical activity. Hope to have been helpful! Feel free to ask any other questions, whenever you need. Greetings!