Hi, For your narration it is clear that your are a 29 year male with hypertension (high BP problem) on atenolol and lisinopril and in a mental stress. You have to attend clinic urgently for your palpitations. I want to know whether the EKG changes mentioned are during episode of palpitations or you have returned to normal before taking EKG. Also your EKG changes suggestive of sinus bradycardia which is most likely due to use of atenolol and there is ST elevation possible early repolarisation in anterolateral leads. You should not neglect these changes, there is rare but definite possibility of heart attack with your symptoms of palpitation, chest discomfort and EKG changes. What you should do is- 1) Visit cardiologist. 2) 2DEcho (echocardiography) needs to be done to know structural damage to heart like regional wall motion abnormalities these may be present after heart attack, enlargement of heart chambers like left ventricular hypertrophy or hypertrophic obstructive cardiomyopathy which is also a rare possibility in your case. 3) Continue your medicines for high BP. 4) If problem of palpitation recurs try to attend emergency clinic during episode only and get EKG done which can give much more information if it is not possible then undergo Holter s monitoring & Electrophysiological study of heart.