Q. What are the causes of palpitations in a 30-year-old tobacco-chewing individual?

Hello doctor,

I am 36 years old. Three years back, I had sudden heart palpitations and nausea, so I visited a doctor who advised me to perform several tests such as creatine, lipid profile, ECG, etc. But, the test reports were all normal. The BP was 140/85 mm of Hg, so the doctor prescribed a tablet Telma 40 mg. After taking the medications, my BP came down to normal, but palpitations were the same, so the doctor changed the medication to tablet Starpress 50 mg, after which the heart palpitations were fine, and the BP became low. Later, the doctor reduced the dosage to tablet Starpress 12.5 mg, and I have been taking the same medicine for three years. But now, I feel like I am breathing a little fast, sometimes with palpitations. I feel discomfort and tightness in my chest and feel like something is stuck in the heart, but not always. My BP is normal at 125/83 mm of Hg, and my heart rate is 66 beats per minute. I do not smoke, but I take tobacco or betel leaves daily. I assume it to be acidity. Kindly provide your advice on the same.