Brief Answer: Cause: Gastrointestinal or cardiac condition Detailed Answer: Hello sir and welcome. Thank you for writing to us. More than asking your doctor, you will habe to give him a detailed description of your presentation (as above) and request for a few investigations (which I shall list later in my response). The possible causes can be either of gastro-intestinal origin or a cardiac condition. The heart beats in a regular rhythmic manner in healthy individuals, but arrhythmias (irreular heart beat) can result. A normal rhythm goes lub-dub lub-dub lub-dub, whereas, an arrhythmia can go lub-dub lub lub lub-dub, etc. To diagnose an arrhythmia or any other cardiac conditin causing this, we will have to request for the following conditions which will predict the complete health of the heart. They are: -EKG -Treadmill test -2D echocardiography (scan of the heart) Once the more serious conditions are ruled out (cardiac) we can then consider the cause for your presentation to be gastro-intestinal. There is one investigation which will be able to diagnose all the conditions under this category, by direct visualization of the gastro-intestinal tract and is called an endoscopy. You may request your doctor for the same once you are considering a digestive tract condition. I hope you find my response both helpful and informative sir. Please feel free to write back to me for any further clarifications or information, I would be more than happy to help. God bless.

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