###Human: ECG report shows down spikes with heart palpitations. Please explain my report. ###Assistant: Hello. I have gone through your query that you frequently have palpitations. But I am sorry to tell you that I am unable to see the ECG image you have attached, it is not getting downloaded probably due to some error or a corrupt file. I kindly request you to please attach a new image of your ECG along with a few more details about your present symptoms. Do you have any known cardiac disease? Whenever you get palpitations do you have any other associated cardiac symptoms like chest pain, shortness of breath, giddiness, or sweating? During palpitations do you feel increased heartbeats or a missing/skipped beats or just a bounding pulse? Do you have anxiety or stress? Kindly get back with the above details and a new ECG image for further discussion and management strategy.