Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Sex - FemaleLocation - EnglandPre-existing conditions - Chiari Malformation with Syrinx, IIHSurgeries in previous 12 months - Stents fitted to transverse sinus & ICP monitorMedications - Aspirin, Antenolol, Acetazolamide and progesterone only pill (to stop cycles, I am sterilised so not used as birth control).Issue - Hi. I am currently waiting an appointment with cardiology following a trip to A&E with tightening pains in the chest when experiencing a double heart beat. This was evident on the ECG the hospital took and appeared similar to the ones taken with my Apple Watch. It has been queried if it may be bigeminy(?). Ive attached an image in the comments from today. The episodes are becoming more frequent and happening for longer periods. I dont want to bother our already busy hospitals when these happen just to have an ECG and be sent away to wait the referral. Can anyone suggest anything I can try to stop this happening? I dont drink given my pre-existing conditions, have never smoked and Ive cut out caffeine already with no results. Thank youETA - Ive taken blood pressure when these are happening and readings are totally normal, reading with picture in comments was 114/66. ### Response: Looks like classic premature atrial contractions (PAC). Can happen in times of high stress. Usually benign, sometimes in the setting of new arrhythmia. Beta blockers can reduce occurrence so maybe cardiology might want to discuss atenolol dose.Sounds like you might getting into a cycle that precedes panic attacks which makes people feel like they are having a heart attack eg short of breath, chest pain. Then fear of a similar episode happening again causes stress and then you cycle right back into stress induced PACs. Breathing exercises are golden when you feel youre about to enter one of these cycles. In through the nose 4 seconds, out through the mouth for 6 seconds. Do this at least 4 times and focus on breathing.See what cardiology has to say. Very unlikely anything serious..