Why do I get strong palpitations with normal ECG and echo findings?

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I have seen the attachment (attachment removed to protect patient identity). Such episodic palpitations may be due to paroxysmal supraventricular tachycardia (PSVT), which occur and spontaneously resolve. They are not present every time so they may not be captured on regular ECG (electrocardiography) strip. Two things can be done, ECG done at the time you have palpitations and Holter monitoring or even longer term monitoring. SVT is not a life-threatening condition but sometimes symptoms of palpitations are troublesome. Yes, there may be other possibilities such as paroxysmal atrial fibrillation, or even anxiety. SVT is common in young females. Treatment is with medicines and if still not controlled then electrophysiological study and catheter ablation. First, I would advise you to have ECG at the time of palpitations or 24 to 48 hours Holter monitoring or loop recording depending upon the frequency of symptoms. I hope this helps.