<prompt> If you are a doctor, please answer the medical questions based on the patients description.hi. im 24 years old. recently ive been out of breath more freuqently like i cant catch it. ive had these heart palpations so bad at times if feel like im gonna fall over and die literally. during these palpations is hard for me to breath or even move around. my right arm has been getting this joint pain for a few months. is this all related? could it be something serious? ive also been extremely fatigue. so much so its difficult for me to about about my day.  <response>: Hello, Your symptoms could be related to possible cardiac arrhythmia. Anxiety can not be excluded either. But, before coming to this conclusion, I would recommend consulting with your attending physician for a physical exam and some tests in order to investigate the possible causes: - a resting ECG and a cardiac ultrasound- a chest X-ray study-thyroid hormone levels for thyroid gland dysfunction- complete blood count for anemia-blood electrolytes for possible imbalance. An ambulatory 24-48 hours ECG monitoring would help investigate for possible cardiac arrhythmia. Hope I have answered your query. Let me know if I can assist you further. Take care Chat Doctor. 