Question: Hello, my name is XXXXXXX I am a 31 year old male. I have a history of hhaving high cholesterol and also high triglycerides since about the age of 15. I have never really been treated for it. Most doctors have usually told me to watch my diet or exercise more, which I have done sporadically. In the past few years I started developing minor skip beats. I've had EKGs done and everything checked out fine. I had a stress test done in 2014 and the doctor said that was fine (military Doctor). I had a second doctor look at those reports and he said that it was fine. In the past year and a half, I have developed some type of arrythmia that has never been caught on an EKG. It has happened while exercising where I can feel my heart go "out of step" and I become breathless. The episodes have also happened during sleep where I wake up and immediately, my heart will jump to about 150 BPM and I feel out of breath. Since the episodes are never caught, I had to do some research online and came up with the valsalva maneuver and that usually helps to "reset" my high BPMs. Those episodes usually last 5-10 minutes. Another part of my health history is having fatty liver. Occasionally, I'll have chest pains but I'm not sure if it's from heartburn (history of stomach problems), costochondritis, or heart related. My BP is usually normal. Diabetes runs in the family but I am not. Thyroid problems are also part of familial history but I don't have any. I had a 24hr holter monitor. Nothing really came up. I have a small history of health anxiety but not overbearing.

Here are my questions:
1.How long does it take for High Triglycerides to affect the heart with something like Atherosclerosis or other heart disease? What are the possibilities of having heart disease at my age either developing or already developed given this history since the age of 15?

2. How concerned should I be at my age and how high is my risk for a heart attack or something similar?

3. I have a new Primary who is treating me, what steps would you recommend I take next? He briefly mentioned doing a month long holter monitor.