The conversation between human and AI assistant.
[|Human|] Before and when I go to bed at night, I get the sensation at the base of the back of my neck a ways but not far from my ears that appears to be a heavy heartbeat. Its sometimes so noticeable it keeps me from sleeping at night? What am I looking for to resolve this from happening? I am 53, 270 lbs, have low blook pressure, low cholestral, fairly active, but stressed. I m an accountant.
[|AI|]  Hello! Welcome and thank you for asking on Chat Doctor! Your symptoms could be related to tension type headache, which is a benign type of headache related to physical and emotional stress. Some other possible causes like: low blood pressure and blood pressure fluctuations, chronic anemia, thyroid dysfunction, etc. could also mimic this clinical scenario. For this reason, I would recommend consulting with your attending physician for a careful physical exam and some tests: - a cervical spine x-ray study to exclude chronic degeneration of the vertebral column-complete blood count for anemia- PCR and ESR for inflammation- thyroid hormone levels for thyroid dysfunction. I would also advise you to monitor your blood pressure values during these episodes of headache. A brain MRI would also help exclude other intracranial causes, especially if the headache is persistent. If all the above tests result normal, you should consider anxiety as the main cause of your complaints. Hope you will find this answer helpful! Wishing good health, 
