@blue717 The echo was to see the flow of blood to make sure you have no narrowing that might pinch off too much oxygen supply to parts of your heart muscle. That much seems to be okay, and frankly, with what you say of your life, you've done very well not to have substantial atherosclerosis. Must be great genes you have! With the stress, we produce cortisol and adrenalin, and eventually it wreaks havoc with the endothelial linings of the major blood vessels. In turn, they get inflamed and that is where the plaque begins to form, just under the endothelium in a layer called the lumen. Plaque does not form where you can put a finger in and feel it, like a lumpy surface of calcified plaque. It's beneath the slippery outer layer that lines all blood vessels.

But, if you have bouts of arrhythmia, it might be sleep apnea, or incipient or progressive metabolic syndrome or diabetes that are the causes. These are the two chief causes of arrhythmia that I know of. There are many triggers to AF, and everyone must find out for themselves what those are....for them. Caffeine, sugar, eating too much and having a distended stomach, alcohol, red wine and its histamines, or preservatives in foods and alcoholic drinks, too hot, too cold.....the list is almost endless. Heartburn.....indigestion, GERD, some drugs, electrolyte imbalances...I did say the list was endless....?

Usually a patient complaining of heart palpitations will be given a monitoring device to wear for at least a full day, but sometimes a week or more is needed to show intermittent arrhythmias. I would hope this is the next step suggested by a cardiologist. If you know you sense something off with your heart, you should have a Holter Monitor, a Zio patch....something. Often PACs go on for years, but they do have a propensity to evolve into atrial fibrillation in some patients. If what you feel is markedly different, this is possibly what is developing. If so, and it checks out, you are in the earliest, and most easily treated, stage called 'paroxysmal.' It comes and goes, so it's not persistent or permanent....which is where you want to be. See a cardiologist, even by Zoom if you must. Also, if you aren't strapped for cash, purchase a Kardia L6 and keep it close to you, in your purse. When you feel lumpy in there, take a recording. It can be uploaded and sent to a cardiologist willing to accept it as 'evidence' of whatever is going on. At the very least what it looks like might induce the cardiologist to invite you in for more comprehensive assessment.